The "Spiked Helmet Sign" on Electrocardiogram Following Left Ventricular Assist Device Implantation: A Case Report.

Authors

Qin Qian, Ling Yin

Published in

Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc. Volume 31. Issue 6. Pages e70237.

Abstract

The ECG "Spiked Helmet Sign," with diffuse concave ST-segment elevation and a J-point spike, typically suggests acute pericarditis. However, after LVAD implantation, it may herald a localized pericardial hematoma and impending tamponade.
A 68-year-old male with end-stage ischemic cardiomyopathy underwent LVAD placement. Hours postoperatively, ECG showed this sign with QTc prolongation (578 ms). Bedside echocardiography revealed a 6-mm localized pericardial/mediastinal hematoma. Troponin I peaked on day 1 and fell. Conservative management was successful.
Recognition of this ECG sign after LVAD surgery should prompt immediate echocardiography to detect pericardial complications.

PMID:
42798138
Bibliographic data and abstract were imported from PubMed on 26 Sep 2026.

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