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Atrioventricular block in accidental hypothermia--a case report
T T Bashour1, A Gualberto, C Ryan
1San Francisco Heart Institute, Seton Medical Center, Daly City, California.
Angiology
|January 1, 1989
Summary
Severe accidental hypothermia can cause advanced atrioventricular block, a finding not previously reported without atrial pacing. This cardiac complication reversed with rewarming, suggesting a direct link to low temperatures.
Area of Science:
- Cardiology
- Internal Medicine
- Emergency Medicine
Background:
- Severe accidental hypothermia presents significant physiological challenges.
- Cardiac conduction abnormalities are known complications of hypothermia.
- Atrioventricular block can range from mild to severe, impacting heart function.
Observation:
- A patient with severe accidental hypothermia developed second-degree and high-grade atrioventricular block.
- The patient also exhibited atrial fibrillation, severe sinus bradycardia, and prominent J (Osborn) waves.
- These cardiac findings were observed spontaneously, not induced by atrial pacing.
Findings:
- This case is the first reported instance of spontaneous advanced atrioventricular block in severe accidental hypothermia.
- The cardiac conduction abnormalities, including atrioventricular block, resolved upon rewarming the patient.
- The resolution of these findings suggests a direct correlation with core body temperature.
Implications:
- Accurate recognition and monitoring of cardiac conduction disturbances are crucial in managing severe hypothermia.
- Understanding the relationship between hypothermia and atrioventricular block can inform clinical practice.
- Further research may elucidate the specific mechanisms by which hypothermia affects cardiac electrical activity.