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Case Reports
. 2021 Jun;116(6):1165-1168.
doi: 10.36660/abc.20201017.

Spiked Helmet Sign: An Atypical Case of Transient ST-Segment Elevation on ECG

[Article in English, Portuguese]
Acácio F Cardoso  1 , Marco Alexander V Akamine  1 , Rafael M Pessoa  1 , Elizabeth T Takitani  1 , José V Kairiyama  1 , Manfredo K Naritoni  1
Affiliations
Case Reports

Spiked Helmet Sign: An Atypical Case of Transient ST-Segment Elevation on ECG

[Article in English, Portuguese]
Acácio F Cardoso et al. Arq Bras Cardiol. 2021 Jun.
No abstract available

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Conflict of interest statement

Potencial conflito de interesse

Não há conflito com o presente artigo

Figures

Figura 1
Figura 1. – Sequência de ECGs da admissão do paciente. 1A) ECG inicial com supradesnivelamento atípico de ST em múltiplas derivações seguidas de macroalternância das ondas T facilmente observadas em V4 e V5 (setas). 1B) Uma hora após o ECG inicial, um novo registro demonstrou uma redução de aproximadamente 50% do supradesnivelamento de ST. Os achados característicos do SHS tornam-se mais evidentes nas derivações V2 e V3. 1C) Seis horas após o ECG inicial, nota-se a resolução completa do supradesnivelamento de ST com a manutenção apenas de alterações discretas da repolarização ventricular.
Figura 2
Figura 2. – Principais achados do SHS no ECG. Uma linha isoelétrica ascendente (círculos vermelhos) é seguida por supradesnivelamento convexo de ST (setas). As alterações se assemelham ao capacete pontiagudo utilizado pelos exércitos da Prússia e Alemanha nos séculos XIX e XX. Legenda: SHS – Spiked helmet sign.
Figure 1
Figure 1. – Sequence of ECG on patient admission. 1A) Initial ECG with atypical ST-segment elevation in multiple leads followed by T-wave macroalternation easily observed in V4 and V5 (arrows). 1B) One hour after the initial ECG, a new scan showed a reduction of approximately 50% in ST-segment elevation. The characteristic findings of SHS are more evident in leads V2 and V3. 1C) Six hours after the initial ECG, complete resolution of ST-segment elevation is seen with only mild ventricular repolarization abnormalities.
Figure 2
Figure 2. – Main SHS findings on ECG. An upward isoelectric line (red circles) is followed by convex ST-segment elevation (arrows). The abnormal findings are similar to the spiked helmet worn by the armies of Prussia and Germany in the 19th and 20th centuries. Key: SHS – Spiked helmet sign.
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References

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