Work

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

Year: 2026

Type: article

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.

Source: Annals of Noninvasive Electrocardiology

DOI: 10.1111/anec.70243

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

Institution: Universidade Federal da Paraíba

Language: English

Topic: Takotsubo Cardiomyopathy and Associated Phenomena

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,840