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ECG of the Month: ECG in an 81-Year-Old Woman
D Luke Glancy1, Robert H Drennan2
1Dr. Glancy is a professor in the Section of Cardiology, Department of Medicine, Louisiana State University Health Sciences Center and the Interim LSU Public Hospital, New Orleans, Louisiana.
Insights
Hypothermia can be indicated by specific electrocardiogram (ECG) abnormalities, including sinus bradycardia, prolonged P-R intervals, and prominent J waves. These findings suggest hypothermia as a potential diagnosis.
Area of Science:
- Cardiology
- Internal Medicine
- Medical Diagnostics
Background:
- Electrocardiography (ECG) is a crucial diagnostic tool in critical care.
- Identifying specific ECG patterns can aid in diagnosing underlying medical conditions.
- Hypothermia presents unique challenges in patient management and diagnosis.
Observation:
- The patient presented with sinus bradycardia (48 beats/min).
- A prolonged P-R interval (0.29 s) was noted.
- A prolonged QT interval (0.53 s) with a corrected QT (QTc) of 0.47 s was observed.
- Prominent J waves were present on the ECG.
- A non-specific ST abnormality was also identified.
Findings:
- The combination of sinus bradycardia, prolonged P-R interval, prolonged QT interval, and prominent J waves are suggestive of hypothermia.
- These ECG findings are characteristic indicators of the physiological effects of cold on cardiac conduction.
Implications:
- Early recognition of hypothermia through ECG findings can lead to prompt therapeutic interventions.
- Understanding these specific ECG abnormalities improves diagnostic accuracy in hypothermic patients.
- This case highlights the importance of ECG interpretation in identifying potentially life-threatening conditions like hypothermia.
Diagnosis:
Sinus bradycardia (48 beats/min), long P-R interval (0.29 s), long QT interval (0.53 s with QTc of 0.47 s), and prominent J waves suggest hypothermia; non-specific ST abnormality.
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