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A Murine Model of Subarachnoid Hemorrhage
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A Murine Model of Subarachnoid Hemorrhage

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Spiked helmet pattern ST elevation in subarachnoid hemorrhage

Robert K Laundon1, Laszlo Littmann2

  • 1Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC, USA.

Journal of Electrocardiology
|December 12, 2018
PubMed

Insights

Subarachnoid hemorrhage (SAH) can mimic ST-segment elevation myocardial infarction (STEMI) on ECGs. Recognizing the "spiked helmet sign" (SHS) is crucial to avoid misdiagnosis and harmful treatments.

Area of Science:

  • Cardiology
  • Neurology
  • Emergency Medicine

Background:

  • Subarachnoid hemorrhage (SAH) can present with electrocardiographic (ECG) abnormalities that mimic acute myocardial infarction.
  • Misinterpreting these ECG changes can lead to delayed diagnosis of SAH and inappropriate cardiac interventions.

Observation:

  • A case report of a 40-year-old female presenting with ECG findings suggestive of ST-segment elevation myocardial infarction (STEMI).
  • Further ECG analysis revealed QT interval prolongation and the characteristic "spiked helmet sign" (SHS).
  • Head CT confirmed a massive SAH with intraventricular hemorrhage, ruling out myocardial infarction.

Findings:

  • The "spiked helmet sign" (SHS) on ECG, along with QT prolongation, was associated with severe central nervous system (CNS) injury in this SAH case.
  • Literature review and internal case files identified similar ECG patterns in other patients with acute CNS conditions.

Implications:

  • Accurate interpretation of ECG findings in the context of neurological emergencies is vital.
  • The SHS may serve as a potential biomarker for CNS injury, prompting further neurological investigation.
  • Timely diagnosis of SAH prevents unnecessary and potentially harmful cardiac interventions.

Keywords:
Critical illnessElectrocardiogramSTEMISpiked helmet signSubarachnoid hemorrhage

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