Spiked Helmet Electrocardiographic Sign in a Patient with a Diagnosis of Thoracoabdominal Aortic Dissection

We report the case of a patient who developed the spiked helmet electrocardiographic (ECG) sign concomitantly with a thoracoabdominal aortic dissection resulting in ischemic functional ileum with gastric distention. Prompt identification of this ECG sign could prevent unnecessary emergent percutaneous cardiac catheterization procedures. (Level of Difficulty: Beginner.).