An Ominous ECG Sign in Critical Care

Crinion, Derek; Abdollah, Hoshiar; Baranchuk, Adrián

doi:10.1161/circulationaha.120.047427

Cited by 13 publications

(14 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several hypotheses have been contemplated, and some propose that SHS is an extreme manifestation of hyperadrenergic state that results in prolongation of repolarization. 5 This hypothesis is supported by the occurrence of SHS in Takotsubo cardiomyopathy and stellate ganglion block. 6,7 Scorpion venom consists of numerous toxins, of which α-toxin causes neuronal stimulation by inhibiting inactivation of the voltage-gated sodium channels.…”

Section: Discussionmentioning

confidence: 90%

Scorpion Sting With ST-Segment Elevation

Bawaskar¹,

Patare²,

Bawaskar

2020

JAMA Intern Med

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 90%

Scorpion Sting With ST-Segment Elevation

Bawaskar¹,

Patare²,

Bawaskar

2020

JAMA Intern Med

View full text Add to dashboard Cite

“…A recent case of Crinion et al showed the "spiked helmet" sign by a patient with septic shock, where however the upward shift preceding the QRS complex could have been given by a negative T wave, and not necessarily by an elevation of the isoelectric line. 6 Interobserver agreement should be investigated in future studies. The differential diagnoses for ST-elevations remain broad and should be scrutinized with attention.…”

Section: Discussionmentioning

confidence: 99%

The “Spiked Helmet” Sign Associated with ST-Elevation Myocardial Infarction: A Case Report

Minotti

Scheler

Sieber

et al. 2021

Clinical Practice and Cases in Emergency Medicine

View full text Add to dashboard Cite

Introduction: The “spiked helmet” sign was first described in 2011 by Littmann and Monroe in a case series of eight patients. This sign is characterized by an ST-elevation atypically with the upward shift starting before the onset of the QRS complex. Nowadays the sign is associated with critical non-cardiac illness. Case Report: An 84-year-old man with a history of three-vessel disease presented to the emergency department with intermittent pain in the upper abdomen. The electrocardiogram revealed the “spiked helmet” sign. After ruling out non-cardiac conditions the catherization lab was activated. The coronary angiography revealed an acute occlusion of the right coronary artery, which was balloon-dilated followed by angioplasty. The first 24 hours went uneventfully with resolution of the “spiked helmet” sign. On the second day, however, the patient died suddenly and unexpectedly. Conclusion: Despite the association with non-cardiac illness, the “spiked helmet” sign can be seen by an acute coronary artery occlusion as an ST-elevation myocardial infarction (STEMI). Reciprocal ST-depression in these cases should raise the suspicion of STEMI.

show abstract

“…1,3 The Spiked Helmet Sign (SHS) has been named for its resemblance to the Prussian military helmet, the Pickelhaube. 4 Though SHS mimics acute myocardial infarction, there is a characteristic upward shift in the baseline preceding the QRS because of delayed giant T-U waves. The ST-segment is in continuity with this shift completing the "helmet" of SHS, with QRS forming the spike on it.…”

Section: Commentarymentioning

confidence: 99%

“…First described in cases of acute abdominal or thoracic pathology, it has subsequently been reported in a variety of acute conditions like intracranial hemorrhage, sepsis, and metabolic derangements. 4 The mechanism is presumed to be a prolongation of repolarization similar to that seen in long QT syndrome secondary to catecholaminergic excess seen in these conditions. Recently, SHS has been described in association with Takotsubo cardiomyopathy also.…”

Section: Commentarymentioning

confidence: 99%