The "Spiked Helmet" Sign Associated with ST-Elevation Myocardial Infarction: A Case Report.
Bruno Minotti1, Jörg Scheler1, Robert Sieber1
1Cantonal Hospital of St. Gallen, Department of Emergency Medicine, St. Gallen, Switzerland.
Clinical Practice and Cases in Emergency Medicine
|August 26, 2021
Summary
The "spiked helmet" sign, typically linked to non-cardiac illness, can indicate acute coronary occlusion. Reciprocal ST-depression on ECG may suggest ST-elevation myocardial infarction (STEMI) in these cases.
Area of Science:
- Cardiology
- Electrocardiography
Background:
- The
- spiked helmet
- sign, characterized by atypical ST-elevation preceding the QRS complex, was first described in 2011.
- It is currently associated with critical non-cardiac conditions.
Purpose of the Study:
- To investigate the potential association between the
- spiked helmet
- sign and acute coronary artery occlusion.
Main Methods:
- A case report of an 84-year-old male with three-vessel disease presenting with abdominal pain.
- Electrocardiogram revealed the
- spiked helmet
- sign.
- Coronary angiography identified acute right coronary artery occlusion, treated with balloon angioplasty.
Main Results:
- The
- spiked helmet
- sign resolved within 24 hours post-intervention.
- The patient experienced sudden unexpected death on the second day.
Conclusions:
- The
- spiked helmet
- sign can be indicative of ST-elevation myocardial infarction (STEMI) due to acute coronary occlusion.
- Reciprocal ST-depression in the presence of this sign should prompt suspicion for STEMI.
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