A patient with hypothermia (defined as rectal temperature < 36.6°C) may show a number of changes in the electrocardiogram.


ECG changes:

(1) tremor artifact associated with shivering

(2) prolongation of RR, PR, QRS and QT intervals

(3) bradycardia (sinus or junctional)

(4) atrial arrhythmias

(4a) atrial flutter

(4b) atrial fibrillation with slow ventricular rate (AV block)

(5) ventricular arrhythmias

(5a) premature ventricular beats

(5b) ventricular tachycardia

(5c) ventricular fibrillation

(6) presence of the Osborn wave (notch in the downstroke of the S wave at the J point)

(7) asystole


In addition, conditions predisposing a person to cold exposure (stroke, myocardial infarction, other) may be evident.


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