Spiked-helmet Sign: A Rare but Alarming Sign on Electrocardiogram

Spiked Helmet Sign was first described by Littman and Munroe in 2011 in a case series of 8 patients. This novel ECG sign is a predictor of death in critically ill patients. It resembles the German military helmet of the Prussian empire. 27-year-old male came with chief complaints of upper epigastric pain and chest pain for 2 hours. ECG showed ST elevation in the anterior and inferior leads, patient was diagnosed as STEMI and lysed with streptokinase, on further interrogation patient had binge of alcohol last night and had sudden onset of upper abdominal pain and Serum amylase and lipase was elevated and USG abdomen showed acute pancreatitis. SHS is associated with critical non cardiac illness and the association with pancreatitis is very rare.