Journal Information
Vol. 40. Issue 4.
Pages 307-308 (April 2021)
Share
Share
Download PDF
More article options
Vol. 40. Issue 4.
Pages 307-308 (April 2021)
Image in Cardiology
Open Access
An abnormal electrocardiogram in a hypothermic man
Um eletrocardiograma anormal num homem hipotérmico
Visits
2372
Paulo M. Araújoa,
Corresponding author
pauloamfa@hotmail.com

Corresponding author.
, Alzira Nunesa, Sofia Torresa, Carlos X. Resendea, Pedro G. Diogoa, Manuel Campeloa,b, Maria J. Maciela,b
a Cardiology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
b Faculdade de Medicina da Universidade do Porto, Portugal
This item has received

Under a Creative Commons license
Article information
Full Text
Download PDF
Statistics
Figures (1)
Full Text
An abnormal ECG in a hypothermic man

A 59-year-old man with a history of alcohol abuse was found fallen and unconscious at his home in the winter. He was severely hypothermic (26°C) and with poor peripheral perfusion. The electrocardiogram showed heart rate of 34 bpm, complete atrioventricular block and inferolateral J-wave elevation, suggestive of Osborn waves (Figure 1A).

Figure 1.

(A) Initial electrocardiogram: Osborn waves (arrows), complete atrioventricular block and tremor artifact; (B) electrocardiogram after patient warming: resolution of previous abnormalities.

(0.37MB).

Blood tests showed rhabdomyolysis; toxicology and alcohol screens were negative and brain computed tomography and echocardiogram were normal.

After re-establishment of normothermia with heated intravenous fluids and external warmer, restoration of sinus rhythm and resolution of the Osborn waves was observed (Figure 1B).

An elevated J point in hypothermia (Osborn wave) was first described by John Osborn in 1953. Although it has been considered pathognomonic of hypothermia, it may also be present in other conditions, such as electrolyte disturbances or brain injuries. Other typical electrocardiographic abnormalities in hypothermia include prolonged PR/QT/QRS duration, conduction abnormalities and atrial or ventricular arrhythmias.

Considering the similarity of Osborn waves to other forms of J-point elevation, such as myocardial infarction or Brugada syndrome, this may lead to an incorrect diagnosis, especially in the setting of an acute event, which reinforces the importance of knowing this pattern and its cause.

Conflicts of interest

The authors have no conflicts of interest to declare.

Copyright © 2021. Sociedade Portuguesa de Cardiologia
Idiomas
Revista Portuguesa de Cardiologia (English edition)
Article options
Tools
en pt

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

By checking that you are a health professional, you are stating that you are aware and accept that the Portuguese Journal of Cardiology (RPC) is the Data Controller that processes the personal information of users of its website, with its registered office at Campo Grande, n.º 28, 13.º, 1700-093 Lisbon, telephone 217 970 685 and 217 817 630, fax 217 931 095, and email revista@spc.pt. I declare for all purposes that the information provided herein is accurate and correct.