Spiked Helmet Sign in the Early Post-Heart Transplantation Period: A Dramatic STEMI Mimic in a Structurally Normal Donor Heart.
Drizia Renally Macedo Lima, Gutemberg de Sousa Dantas Segundo, Gabriel Pelegrineti Targueta et al.
✦ AI-curated · Sources linked
Case in brief
A 36-year-old woman with severe dilated cardiomyopathy underwent heart transplantation and subsequently developed subarachnoid hemorrhage and septic shock. Her ECG showed a spiked helmet sign pattern with repolarization abnormalities and QT prolongation. The ECG changes resolved after intensive support, but she later died from infectious complications.
What made this case unusual
The spiked helmet sign occurred early after transplantation in a structurally normal donor heart, an unusual presentation that the report describes as previously unreported.
Diagnostic / clinical pearl
A spiked helmet sign can occur in a structurally normal transplanted heart during critical illness; interpret it in the clinical context rather than assuming primary structural cardiac disease.
Why it matters
The case links this ECG pattern with severe extracardiac illness and a poor outcome, although the ECG abnormalities resolved before the patient died from infectious complications.