The "Spiked Helmet" Sign Associated with ST-Elevation Myocardial Infarction : A Case Report
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:5 |
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| Enthalten in: |
Clinical practice and cases in emergency medicine - 5(2021), 2 vom: 26. Mai, Seite 152-154 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Minotti, Bruno [VerfasserIn] |
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| Anmerkungen: |
Date Revised 13.04.2023 published: Print Citation Status PubMed-not-MEDLINE |
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| doi: |
10.5811/cpcem.2021.1.50921 |
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NLM329801058 |
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| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
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| 700 | 1 | |a Scheler, Eva |e verfasserin |4 aut | |
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