Electrocardiographic manifestations of hypothermia and the 'J (Osborn) wave'
© BioMed Central Ltd 2007
Published: 19 June 2007
Hypothermia is defined as a core temperature less than 35°C. Critical trauma patients usually are hypothermic. A reversible coma simulating cerebral death could be one of the clinical manifestations of hypothermia. Life-threatening ventricular arrhythmias could be evident when moving the patient and during the rewarming process. Electrocardiographic manifestations of hypothermia are: bradycardia, absence of atrial activity, narrow QRS complexes and a prolonged QT interval. The presence of the 'J (Osborn) wave', a second upward wave immediately following S waves, is pathognomonic. The 'J (Osborn) wave' is the result of the difference of potential action between the epicarde and endocarde during phases 1 and 2 of the ventricular repolarisation and is related to increase in mortality.
To report a case of penetrating thoracic gunshot wound with electrocardiographic manifestations of hypothermia, including a 'J (Osborn) wave', who died.
Case report and literature review.
The search for electrocardiographic manifestations of hypothermia should be part of the routine for critical trauma patients and, when reported, should alert the surgical team about the possibility of supporting a bad prognosis.