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Fall S, Farhat SB, Chelly A, Kaddour H, Saad SB, El Hedi AM, Slim M, Thabet H, Ouannes S, Gribaa R, Elhraiech A, Elyes N. The spiked helmet sign in a patient with erysipelas: an alarming electrocardiogram sign (a case report). Pan Afr Med J 2023; 46:58. [PMID: 38223872 PMCID: PMC10787137 DOI: 10.11604/pamj.2023.46.58.40438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 10/07/2023] [Indexed: 01/16/2024] Open
Abstract
Early diagnosis of the spiked helmet sign is challenging. This ST-elevation myocardial infarction mimic was first described in 2011 by Littmann and colleagues and was linked to severe non-coronary pathologies, with a high risk of mortality. We present a case of a 60-year-old female patient who developed severe erysipelas with sepsis associated with severe hypokalemia. She had a spiked helmet sign on her routine electrocardiogram at hospital admission. We performed a coronary angiogram that showed no culprit artery. She developed afterward an ischemic stroke. Through intensive management of the patient's sepsis and electrolyte disturbance, she had a favorable outcome.
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Affiliation(s)
- Salihou Fall
- Cardiology Department, Sahloul University Hospital, Faculty of Medicine Ibn El Jazzar of Sousse, University of Sousse, Sousse, Tunisia
| | - Sameh Ben Farhat
- Cardiology Department, Sahloul University Hospital, Faculty of Medicine Ibn El Jazzar of Sousse, University of Sousse, Sousse, Tunisia
| | - Ahmed Chelly
- Cardiology Department, Sahloul University Hospital, Faculty of Medicine Ibn El Jazzar of Sousse, University of Sousse, Sousse, Tunisia
| | - Hella Kaddour
- Cardiology Department, Sahloul University Hospital, Faculty of Medicine Ibn El Jazzar of Sousse, University of Sousse, Sousse, Tunisia
| | - Saeb Ben Saad
- Cardiology Department, Sahloul University Hospital, Faculty of Medicine Ibn El Jazzar of Sousse, University of Sousse, Sousse, Tunisia
| | - Ahmed Mohamed El Hedi
- Emergency Medical Service Department (SAMU03), Sahloul University Hospital, Faculty of Medicine Ibn El Jazzar of Sousse, University of Souse, Sousse, Tunisia
| | - Mehdi Slim
- Cardiology Department, Sahloul University Hospital, Faculty of Medicine Ibn El Jazzar of Sousse, University of Sousse, Sousse, Tunisia
| | - Houssem Thabet
- Cardiology Department, Sahloul University Hospital, Faculty of Medicine Ibn El Jazzar of Sousse, University of Sousse, Sousse, Tunisia
| | - Sami Ouannes
- Cardiology Department, Sahloul University Hospital, Faculty of Medicine Ibn El Jazzar of Sousse, University of Sousse, Sousse, Tunisia
| | - Rym Gribaa
- Cardiology Department, Sahloul University Hospital, Faculty of Medicine Ibn El Jazzar of Sousse, University of Sousse, Sousse, Tunisia
| | - Aymen Elhraiech
- Cardiology Department, Sahloul University Hospital, Faculty of Medicine Ibn El Jazzar of Sousse, University of Sousse, Sousse, Tunisia
| | - Neffati Elyes
- Cardiology Department, Sahloul University Hospital, Faculty of Medicine Ibn El Jazzar of Sousse, University of Sousse, Sousse, Tunisia
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