The differential diagnosis of electrocardiographic (ECG) ST-segment elevation includes
a multitude of cardiopulmonary pathologies, including myocardial infarction, pericarditis,
myocarditis, pulmonary embolism, takotsubo syndrome, ventricular aneurysm, and Brugada
syndrome, among others (
1
). However, under the appropriate clinical presentation, this ECG finding expands to
include extrathoracic pathology as part of the differential. A lesser-known manifestation
of ST-segment elevation referred to as the “spiked helmet” sign (SHS) may represent
a key diagnostic clue to the emergency provider of a critically evolving intra-abdominal
pathology. We present a case in which the ECG findings of the SHS provided a diagnostic
clue and expedited the diagnosis and management of a patient with severe intra-abdominal
pathology.To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 10, 2019
Accepted:
June 8,
2019
Received in revised form:
June 1,
2019
Received:
March 28,
2019
Footnotes
Reprints are not available from the authors.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
