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Pickelhaube – Tee-Pee ECG Double Whammy!

Year: 2025

Type: article

Abstract: A young patient admitted with multiple abdominal and chest gunshot wounds is in shock with multiple electrolyte abnormalities. Initial electrocardiogram (ECG) revealed a dome-and-spike pattern in the inferior leads (Fig. A) resembling a Prussian spiked helmet (Pickelhaube), reflective of severe systemic illness, shock, elevated lactate level and abdomino-thoracic injuries. The anterior leads revealed peaking of the T waves indicative of hyperkalemia in addition to prominent U waves reflective of initial low ionized calcium and low magnesium, giving the appearance of a teepee. Multiple surgeries in addition to electrolyte adjustment resulted in stabilization and resolution of the acute ECG findings (Fig. B).

Source: Zenodo (CERN European Organization for Nuclear Research)

DOI: 10.5281/zenodo.17393801

Authors: Goulding-Avedisian, Taylor, Acharya, Deeksha, Qureshi, Abdul Moiz, Omar, Bassam, Manoharan, Suganya, Malozzi, Christopher

Institutions: University of South Alabama Medical Center, University of South Alabama

Language: English

Topic: Potassium and Related Disorders

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: green

OpenAlex ID: W7092668505

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