Hypothermia electrocardiogram

Jump to navigation Jump to search

Hypothermia Microchapters

Home

Patient Information

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Hypothermia from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Hypothermia electrocardiogram On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Hypothermia electrocardiogram

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Hypothermia electrocardiogram

CDC on Hypothermia electrocardiogram

Hypothermia electrocardiogram in the news

Blogs on Hypothermia electrocardiogram

Directions to Hospitals Treating Hypothermia

Risk calculators and risk factors for Hypothermia electrocardiogram

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Hypothermia is characterized on the EKG by sinus bradycardia, PR prolongation, QT prolongation, QRS prolongation and Osborn waves.

Rate

There is a slowing of the sinus rate.

Rhythm

About 50 to 60% of these patients develop atrial fibrillation. VF may also occur.

PR Interval

There is prolongation of the PR interval.

QRS Interval

There is prolongation of the QRS which is often due to the appearance of the J wave

QT Interval

There is prolongation of the QT interval

Osborn Waves

The most typical finding is the appearance of the Osborne J wave, an extra deflection between the QRS complex and the T wave. Osborn waves are positive deflections occurring at the junction between the QRS complex and the ST segment, where the S point, also known as the J joint, has a myocardial infarction-like elevation. Osborn waves are more prominent in the left precordial leads. They increases in size with decreasing temperature. They are caused by a current of injury, delayed ventricular depolarization, or early repolarization.

Osborn waves may first appear on the ECG for temperatures less tahn 91.4 degrees Fahrenheit (33 degrees Celsius), and consistently appear when when the temperature falls below 25 degrees Centigrade.

There is variability in the morphology of Osborn waves as all J wave deflections do not look alike. Some Osborn waves are merely elevations of ST segments in leads V1 and V2, whereas others are of the "spike-and-dome" variety. Given the variability in morphology, a variety of mechanisms may be responsible for the size and shape of J wave deflections.

Shown below is an example of the "spike and dome" variant of the Osborn wave:

An Osborn J wave
An Osborn J wave

Shown below is an Osborn wave in an 81-year-old male with a core temperature 89.5 degrees F (31.94 C):


Electrocardiographic Examples

Examples of Osborn Waves in the Setting of Hypothermia

Shown below is the 12 lead ECG of a patient with a body temperature of 32 degrees Celsius. Note the sinus bradycardia, the prolonged QT interval (QTc is not prolonged) and the Osborn J wave, most prominently in leads V2-V5:


Shown below is An ECG of a patient with a body temperature of 28 degrees Celsius:


Shown below are Osborn J waves due to hypothermia:


Shown below are Osborn J waves due to hypothermia:

References

Template:WH Template:WS