{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T06:38:05Z","timestamp":1792737485516,"version":"4.5.0"},"reference-count":3,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:00:00Z","timestamp":1792454400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:00:00Z","timestamp":1792454400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Noninvasive Electrocardiol"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>A 36\u2010year\u2010old 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.<\/jats:p>","DOI":"10.1111\/anec.70243","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T07:46:06Z","timestamp":1792482366000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Spiked Helmet Sign in the Early Post\u2010Heart Transplantation Period: A Dramatic\n                    <scp>STEMI<\/scp>\n                    Mimic in a Structurally Normal Donor Heart"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5881-3002","authenticated-orcid":false,"given":"Drizia Renally Macedo","family":"Lima","sequence":"first","affiliation":[{"name":"Federal University of Para\u00edba (UFPB)  Jo\u00e3o Pessoa Para\u00edba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8895-0558","authenticated-orcid":false,"given":"Gutemberg de Sousa Dantas","family":"Segundo","sequence":"additional","affiliation":[{"name":"Dom Jos\u00e9 Maria Pires Metropolitan Hospital  Jo\u00e3o Pessoa Para\u00edba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7872-213X","authenticated-orcid":false,"given":"Gabriel Pelegrineti","family":"Targueta","sequence":"additional","affiliation":[{"name":"Federal University of Para\u00edba (UFPB)  Jo\u00e3o Pessoa Para\u00edba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7709-0221","authenticated-orcid":false,"given":"Roberta Tavares Barreto","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Federal University of Para\u00edba (UFPB)  Jo\u00e3o Pessoa Para\u00edba Brazil"},{"name":"Dom Jos\u00e9 Maria Pires Metropolitan Hospital  Jo\u00e3o Pessoa Para\u00edba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6685-7491","authenticated-orcid":false,"given":"Alex Tiburtino","family":"Meira","sequence":"additional","affiliation":[{"name":"Federal University of Para\u00edba (UFPB)  Jo\u00e3o Pessoa Para\u00edba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4112-3600","authenticated-orcid":false,"given":"Guilherme Augusto Teodoro","family":"Athayde","sequence":"additional","affiliation":[{"name":"Federal University of Para\u00edba (UFPB)  Jo\u00e3o Pessoa Para\u00edba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,20]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelectrocard.2019.06.002"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.4065\/mcp.2011.0647"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.31083\/j.rcm2409272"}],"container-title":["Annals of Noninvasive Electrocardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anec.70243","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/anec.70243","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anec.70243","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T05:46:49Z","timestamp":1792734409000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/anec.70243"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,20]]},"references-count":3,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1111\/anec.70243"],"URL":"https:\/\/doi.org\/10.1111\/anec.70243","archive":["Portico"],"relation":{},"ISSN":["1082-720X","1542-474X"],"issn-type":[{"value":"1082-720X","type":"print"},{"value":"1542-474X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,20]]},"assertion":[{"value":"2026-07-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70243"}}