Case report of a cardiac Harlequin syndrome—electrical storm during venoarterial extracorporeal membrane oxygenation

In severe sepsis-related cardiogenic shock, cardiac output is likely to recover. Venoarterial extracorporeal membrane oxygenation is a potential bridge to recovery. Apart from textbook knowledge, Harlequin syndrome can exclusively cause coronary ischaemia, leading to ST-segment elevations and electrical storm. ECGs reveal ST-elevations for early detection. Isolated cardiac Harlequin syndrome can be overlooked or misinterpreted as result of coronary artery disease, but needs immediate therapy to save the patient's life (e.g. V-AV-ECMO).