The “spiked helmet” sign is characterized by marked prolongation of the QT interval, often > 550 ms, associated with ST-segment elevation. It has been observed in cases of intracranial hemorrhage, sepsis, and severe metabolic disorders.
Electrocardiographic Criteria
- Upward displacement of the baseline as a result of the elevated ST segment
- Marked prolongation of the QT interval
- Formation of a dome (representing ST-segment elevation) with a spike (representing the QRS complex), resembling the shape of a Prussian military helmet
ECG Showing the Spiked Helmet Sign
Further Reading
Related Topics
References
- Littmann L, Monroe MH. The “Spiked Helmet” Sign: A New Electrocardiographic Marker of Critical Illness and High Risk of Death. Mayo Clin Proc. 2011;86(12):1245–6.
- Laundon RK, Littmann L. Spiked helmet pattern ST elevation in subarachnoid hemorrhage. J Electrocardiol. 2019;52:96–8.
- Mahmoudi E, Hui JMH, Leung KSK, Satti DI, et al. Spiked Helmet Electrocardiographic Sign-A Systematic Review of Case Reports. Curr Probl Cardiol. 2023;48(3):101535.
