International Journal of Clinical & Medical Images

ECG has been the most important tool for diagnosis of cardiac ailments for so long and has maintained its status for the same despite tremendous advances in technology. Of all things ECG is the most important investigation for diagnosis and treatment of acute coronary syndrome. We like to propose a new sign in ECG in inferior wall myocardial infarction. 

We like to call it “Dead Man Sign”, as this sign resembles a dead man lying on the ground as shown on the circles below.

This sign is formed on ECG by very high ST-Elevation in leads II and aVF associated with similar mirror images reciprocal changes in leads I and aVF. The anatomical lesion associated with this ECG sign is total or near total occlusion of right coronary artery.

 We have observed that this sign is easily recognisable and associated with RV extention of MI associated with multiple tachy and bradyarrythmias mostly SVTs and predicts a stormy course.