{Reference Type}: Journal Article
{Title}: Electrocardiographic semi-spiked helmet sign in critically Ill patients: A case series.
{Author}: Sasmita BR;Luo S;Huang B;
{Journal}: Medicine (Baltimore)
{Volume}: 102
{Issue}: 43
{Year}: 2023 Oct 27
{Factor}: 1.817
{DOI}: 10.1097/MD.0000000000035661
{Abstract}: <B>BACKGROUND: </B>ST-segment elevation on electrocardiogram (ECG) is an alarming sign. Although acute myocardial infarction (AMI) is the most common cause of ST-segment elevation, many non-ischemic conditions may produce pseudo-ST segment elevation. Spiked Helmet (SH) sign is one of the pseudo-ST segment elevations that is associated with critical illness and high risk of death. SH sign was characterized by an upward shift starting before the onset of the QRS complex; however, we found some patients presented with a peculiar characteristic on ECG with an upward convex ST-segment elevation after the QRS wave but without elevation before the QRS wave, therefore called Semi-SH sign. Also, this electrocardiographic feature exists in patients with critical disease and is related to poor prognosis. The purpose of this case series is to describe the electrocardiographic Semi-SH sign and enhance the awareness of such electrocardiographic manifestation for clinicians.<BR><B>METHODS: </B>This case series explores the possibility of severe infection induced electrocardiographic changes resembling spiked-helmet sign.<BR><B>METHODS: </B>Sepsis-induced secondary myocardial injury or coronary vasospasm.<BR><B>METHODS: </B>Gastric decompression, antibiotics, diuretics, advanced life support.<BR><B>RESULTS: </B>The outcome of this case series is the association of the electrocardiographic Semi-SH sign with the prognosis. All 3 patients died several days post manifestation of electrocardiographic Semi-SH sign.<BR><B>CONCLUSIONS: </B>Like SH sign, electrocardiographic Semi-SH sign is a life-threatening or deadly ECG sign, and therefore early recognition and aggressive treatment are important.