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VOLUME 18 , ISSUE 4 ( April, 2014 ) > List of Articles


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

Ajay Agarwal, Timothy G. Janz, Naga V. Garikipati

Keywords : Critical illness, electrocardiogram, mortality, myocardial infarction

Citation Information : Agarwal A, Janz TG, Garikipati NV. Spiked helmet sign: An under-recognized electrocardiogram finding in critically ill patients. Indian J Crit Care Med 2014; 18 (4):238-240.

DOI: 10.4103/0972-5229.130576

License: CC BY-ND 3.0

Published Online: 01-04-2014

Copyright Statement:  Copyright © 2014; Jaypee Brothers Medical Publishers (P) Ltd.


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.

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