Hypothermia electrocardiogram
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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.
Electrocardiographic Findings
- Osborn waves may appear on the ECG for temperatures less tahn 91.4 degrees Fahrenheit (33 degrees Celsius)
- There is a slowing of the sinus rate
- Prolongation of the PR interval and the QTc
- Prolongation of the QRS is often due to the appearance of the J wave
- The most typical finding is the appearance of the Osborne J wave, an extra deflection between the QRS complex and the T wave.
- Consistently found when the temperature falls below 25 degrees Centigrade.
- More prominent in the left precordial leads
- Increases in size with decreasing temperature
- Caused by a current of injury, delayed ventricular depolarization, or early repolarization
- About 50 to 60% of these patients develop atrial fibrillation. VF may also occur.
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An Osborn J wave -
Osborn wave. 81-year-old black male with BP 80/62 and temperature 89.5 degrees F (31.94 C) -
A 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 -
An ECG of a patient with a body temperature of 28 degrees Celsius.
