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.
- Hanna E.B.
- Glancy D.L.
ST-segment elevation: differential diagnosis, caveats.
Cleve Clin J Med. 2015; 82: 373-384
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- ST-segment elevation: differential diagnosis, caveats.Cleve Clin J Med. 2015; 82: 373-384
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Published online: August 10, 2019
Accepted: June 8, 2019
Received in revised form: June 1, 2019
Received: March 28, 2019
Reprints are not available from the authors.
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