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Updated: May 28, 2026

In vitro Assessment of Myocardial Protection following Hypothermia-Preconditioning in a Human Cardiac Myocytes Model
Published on: October 27, 2020
A Reversible ECG Signature of Hypothermia
Jacopo Costantino1, Daniele Porcelli2, Barbara Romani2
1Department of Cardiology, Ospedale San Pietro Fatebenefratelli, Rome, Italy; Department of Medical and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy; Department of Medicine, University of Padova, Padua, Italy.
Case Summary:
Accidental hypothermia is associated with distinctive electrocardiographic abnormalities that may precede malignant arrhythmias. We report the case of a 31-year-old homeless man admitted for severe hypothermia whose admission electrocardiogram (ECG) showed sinus bradycardia, prominent Osborn (J) waves in inferolateral leads, and marked QT prolongation. No metabolic, toxic, or structural cardiac abnormalities were identified. With active rewarming and supportive care, a progressive and complete normalization of the ECG occurred within 48 hours. This case highlights the diagnostic value, pathophysiology, and reversibility of hypothermia-related ECG findings.
Take-Home Messages:
Accidental hypothermia can produce characteristic ECG changes, including prominent Osborn waves and marked QT prolongation. These abnormalities may completely resolve after rewarming in the absence of electrolyte, toxic, or structural cardiac disease.
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