Spiked Helmet Sign in the Early Post-Heart Transplantation Period: A Dramatic STEMI Mimic in a Structurally Normal Donor Heart.

Authors

Drizia Renally Macedo Lima, Gutemberg de Sousa Dantas Segundo, Gabriel Pelegrineti Targueta, Roberta Tavares Barreto Teixeira, Alex Tiburtino Meira, Guilherme Augusto Teodoro Athayde

Published in

Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc. Volume 31. Issue 6. Pages e70243.

Abstract

A 36-year-old woman with severe dilated cardiomyopathy (LVEF 14%, NYHA IV) underwent heart transplantation. Postoperatively, she developed subarachnoid hemorrhage and septic shock. The ECG revealed a spiked helmet sign (SHS) pattern, with repolarization abnormalities and QT prolongation. Despite transient clinical improvement and resolution of the ECG changes after intensive support, the patient died due to infectious complications. This case highlights the occurrence of SHS in the early posttransplant period in a structurally normal donor heart, a previously unreported presentation, reinforcing its extracardiac origin and association with critical illness and poor prognosis.

PMID:
42898018
Bibliographic data and abstract were imported from PubMed on 20 Oct 2026.

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