ArticleAnnals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc2026
The "Spiked Helmet Sign" on Electrocardiogram Following Left Ventricular Assist Device Implantation: A Case Report.
Article in Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe 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. CASE PRESENTATION: 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.
conclusionRecognition of this ECG sign after LVAD surgery should prompt immediate echocardiography to detect pericardial complications.
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