[Electrocardiographic manifestations of severe accidental hypothermia: report of one case]

We report a 77-year-old female patient who was admitted to the Emergency Department with impairment of consciousness, hypotension, bradycardia and hypothermia. She required endotracheal intubation and transfer to Intensive Care Unit (ICU). Computed tomography of the brain showed no lesions. Electrocardiogram showed abnormalities suggestive of severe hypothermia (bradycardia, marked elevation of J point associated with ST depression, a negative T wave in V2 to V6 and prolongation of QTc), which was confirmed with a pulmonary artery catheter. Myxedema coma, infections and neurological diseases were discarded. The cause of severe hypothermia was unclear, and the probable source was suspected to be accidental. After intensive treatment the patient improved, achieving normalization of electrocardiographic changes, recovery of organic functions and she was discharged home after 22 days.