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QJM Advance Access originally published online on August 1, 2008
QJM 2008 101(11):907; doi:10.1093/qjmed/hcn090
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© The Author 2008. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Cold-hearted—the electrocardiogram in hypothermia

J Gallagher, Z.A. Memon and C.S. Mobed

Emergency Department, South Tipperary General Hospital, Ireland.

email: drjgallagher{at}gmail.com

A 50-year-old woman was brought to the Emergency Department following prolonged hypothermia. Her core temperature on arrival was 32.3°C. Her electrocardiogram showed classic changes associated with hypothermia—baseline tremor, sinus bradycardia, a PR interval at the upper limit of normal (200 ms), a prolonged QTc (484 ms) and prominent Osborn waves (arrow).

Osborn waves, also known as ‘J waves’, were first described by Dr John Osborn in 1953 during experimental hypothermia. They result from a transmural voltage gradient mediated by the transient outward potassium current (Ito) in epicardium but not endocardium leading to accentuation of the spike-and-dome morphology of the action potential in M and epicardial cells. Osborn waves may also be seen in hypercalcaemia, Brugada syndrome and subarachnoid haemorrhage.

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This Article
Right arrow Extract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
101/11/907    most recent
hcn090v1
Right arrow Alert me when this article is cited
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Right arrow Articles by Gallagher, J
Right arrow Articles by Mobed, C.S.
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Right arrow Articles by Mobed, C.S.
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