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Osborn wave in accidental hypothermia.
Ernest Matthew Quin1, Honey East, Michael R McMullan
1University of Mississippi Medical Center, Department of Internal Medicine, Jackson 39216, USA. equin@medicine.umsmed.edu
Journal of the Mississippi State Medical Association
|October 18, 2007
Summary
Accidental hypothermia, often caused by cold exposure, can lead to altered mental status. Characteristic electrocardiogram changes, like the Osborn wave, suggest hypothermia, with warming resolving abnormalities.
Area of Science:
- Internal Medicine
- Cardiology
- Emergency Medicine
Background:
- Hypothermia results from various causes, most commonly accidental cold exposure.
- Diagnosis relies heavily on patient history and physical examination.
- Typical laboratory abnormalities can accompany hypothermia.
Observation:
- An elderly male presented with altered mentation after prolonged cold exposure.
- Physical examination confirmed hypothermia.
- Electrocardiogram (ECG) revealed characteristic changes suggestive of hypothermia.
Findings:
- Extensive workup identified only adrenal insufficiency.
- ECG abnormalities resolved upon rewarming the patient.
- The Osborn wave on ECG is a key, though not pathognomic, indicator of hypothermia.
Implications:
- Prompt recognition and warming are crucial for managing hypothermia.
- ECG findings, particularly the Osborn wave, aid in diagnosis.
- Atrial fibrillation and shivering artifact are predictors of outcome in hypothermia.
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