'Shark fin' if no clinical history provided what is your diagnosis based on ECG only and why??#cardiotwitter #EPeeps @smithECGBlog @amalmattu @EM_RESUS @ecgrhythms 
Little surprised for every one ( Yes this is not a case of STEMI)
24y/female , 2nd post op day for pyloric stenosis , referred from outside hospital to our institute considering AWMI with shock
My thoughts on ECG
Shark fin ST elevation in all leads except V1 and AVR which represents basal area of heart so condition in which whole myocardium is involved except basal area is takotsubo cardiomyopathy ( 3rd Shark fin in 6 months so I immediately recognised)
Shark fin ST elevation in all leads except V1 and AVR which represents basal area of heart so condition in which whole myocardium is involved except basal area is takotsubo cardiomyopathy ( 3rd Shark fin in 6 months so I immediately recognised)
Coronary angiogram
LV angiogram classic takotsubo cardiomyopathy
Final thought - shark fin kind of ST elevation probably represents severe transmural injury ( ischemic or non ischemic)
Thank you everyone.
