Spiked helmet sign: An under-recognized electrocardiogram finding in critically ill patients

Ajay Agarwal; Timothy G Janz; Naga V Garikipati

doi:10.4103/0972-5229.130576

Spiked helmet sign: An under-recognized electrocardiogram finding in critically ill patients

Indian J Crit Care Med. 2014 Apr;18(4):238-40. doi: 10.4103/0972-5229.130576.

Authors

Ajay Agarwal¹, Timothy G Janz¹, Naga V Garikipati²

Affiliations

¹ Department of Medicine, Dayton Veteran Affairs Medical Center, Dayton, OH 45428, USA ; Wright State University, Dayton, OH 45409, USA.
² Wright State University, Dayton, OH 45409, USA.

Abstract

A 77-year-old male patient presented with rhabdomyolysis. He developed progressive respiratory failure and acute respiratory distress syndrome during his hospital stay requiring mechanical ventilation. An electrocardiogram during mechanical ventilation showed findings suggestive of ST elevation myocardial infarction. Closer review showed dome and spike findings that have been likened to a "spiked helmet." This finding has been associated with significant mortality. We discuss this under-recognized finding and the potential contributing mechanisms.

Keywords: Critical illness; electrocardiogram; mortality; myocardial infarction.

Publication types

Case Reports