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Electrocardiographic spiked-helmet sign in critical non-cardiac illness
Journal article   Peer reviewed

Electrocardiographic spiked-helmet sign in critical non-cardiac illness

Offdan Narvaez-Guerra, Brian Osorio, Bryon Gentile and Freddy Del-Carpio Munoz
BMJ case reports, Vol.16(10), p.e254546
10/09/2023
DOI: 10.1136/bcr-2022-254546
PMCID: PMC10565134
PMID: 37813557
url
https://pmc.ncbi.nlm.nih.gov/articles/PMC10565134/pdf/bcr-2022-254546.pdfView
Open Access

Abstract

The spiked-helmet sign (SHS) is an electrocardiographic finding characterised by a distinctive pattern associated with critical illness, resolving once the clinical condition improves. While the underlying mechanism remains uncertain, different mechanisms have been proposed to account for these findings including changes in intrathoracic or intra-abdominal pressures, transient compression of the coronary arteries, repolarisation abnormalities and electromechanical artefacts. We describe the development of the SHS in a patient with underlying left bundle branch pacing following the development of respiratory failure due to haemoptysis and review proposed mechanisms for its pathophysiology.
General & Internal Medicine Life Sciences & Biomedicine Medicine, General & Internal Science & Technology

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