Electrocardiographic changes by accidental hypothermia in an urban and a tropical region

Souza, Davisson Charles Cangussu de; Pérez‐Riera, Andrés Ricardo; Bombig, Maria Teresa Nogueira; Francisco, Yoná Afonso; Brollo, Luigi; Filho, Bráulio Luna; Dubner, Sérgio; Schapachnik, Edgardo; Póvoa, Rui Manuel dos Santos

doi:10.1016/j.jelectrocard.2006.08.094

Cited by 27 publications

(29 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Hypothermia is a life-threatening condition that is defined as a core temperature below 35 ° C. Our patient had a moderate degree of hypothermia as his rectal temperature was 29.5 ° C. ECG changes in hypothermia include prolongation of all ECG intervals (PR, RR, QRS, and QT), J (Osborn) waves, sinus bradycardia, atrial fibrillation, and junctional bradycardia [7] . The changes in our patient's ECG were reversible after correction of the hypothermia.…”

Section: Discussionmentioning

confidence: 96%

Hypothermia with Pneumonia: A Rare Presentation of Brucellosis

Ghoussein

Hegazi²

2011

Med Princ Pract

View full text Add to dashboard Cite

Objective: To report a very rare form of brucellosis presenting with hypothermia and pneumonia. Clinical Presentation and Intervention: A 41-year-old male shepherd presented with a depressed level of consciousness. Clinically, his rectal temperature was 29.5°C, and he was cold, apathetic, hyporeflexic, and hypotensive, with atrial fibrillation. He had clinical and radiological evidence of bilateral bronchopneumonia. Blood culture and serologic testing were positive for Brucella melitensis. The patient recovered completely after proper management of the hypothermia and treatment of the brucellosis with antibiotics (doxycycline 100 mg orally twice daily for 6 weeks and streptomycin 1 g i.m. daily for 21 days). Conclusion: This case shows that brucellosis should be considered in the differential diagnosis of septicemic patients presenting with hypothermia.

show abstract

Section: Discussionmentioning

confidence: 96%

Hypothermia with Pneumonia: A Rare Presentation of Brucellosis

Ghoussein

Hegazi²

2011

Med Princ Pract

View full text Add to dashboard Cite

show abstract

“…Previous experimental or clinical studies examining the effects of cold on cardiac electrical function have involved intense whole-body exposures, such as hypothermia [14], [15], [33] and immersion to cold water [12] or employed exercise in cold [16]–[18]. These studies have shown several different effects on ECG, such as atrial [12], [14], [15], [33] and ventricular [15], [33] arrhythmias, interval prolongation [14], [15], [33], T-wave abnormalities [14], [15], Osborne waves [14], [15], [33], and pronounced ST-depression during exercise among cardiac patients [16], depending on cold exposure duration and its intensity.…”

Section: Discussionmentioning

confidence: 99%

“…These studies have shown several different effects on ECG, such as atrial [12], [14], [15], [33] and ventricular [15], [33] arrhythmias, interval prolongation [14], [15], [33], T-wave abnormalities [14], [15], Osborne waves [14], [15], [33], and pronounced ST-depression during exercise among cardiac patients [16], depending on cold exposure duration and its intensity. Only a few studies have examined cardiac electrical activity under superficial or local cold exposure, such as facial cooling with [34] or without breath holding [13].…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies using pronounced whole-body cooling and hypothermia have detected electrocardiographic (ECG) manifestations such as the J (Osborne) waves, interval prolongation, T-wave abnormalities, and atrial and ventricular arrhythmias [12], [14], [15]. Furthermore, exercise in a cold environment induces pronounced cardiac symptoms in patients with cardiac disease [16], [17] and impairs post exercise cardiovagal regulation among healthy subjects [18].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cardiac Repolarization and Autonomic Regulation during Short-Term Cold Exposure in Hypertensive Men: An Experimental Study

et al. 2014

View full text Add to dashboard Cite

ObjectivesThe aim of our study was to assess the effect of short-term cold exposure, typical in subarctic climate, on cardiac electrical function among untreated middle-aged hypertensive men.MethodsWe conducted a population-based recruitment of 51 hypertensive men and a control group of 32 men without hypertension (age 55–65 years) who underwent whole-body cold exposure (15 min exposure to temperature −10°C, wind 3 m/s, winter clothes). Conduction times and amplitudes, vectorcardiography, arrhythmias, and heart rate variability (autonomic nervous function) were assessed.ResultsShort-term cold exposure increased T-peak to T-end interval from 67 to 72 ms (p<0.001) and 71 to 75 ms (p<0.001) and T-wave amplitude from 0.12 to 0.14 mV (p<0.001) and from 0.17 to 0.21 mV (p<0.001), while QTc interval was shortened from 408 to 398 ms (p<0.001) and from 410 to 401 ms (p<0.001) among hypertensive men and controls, respectively. Cold exposure increased both low (from 390 to 630 ms2 (p<0.001) and 380 to 700 ms2 (p<0.001), respectively) and high frequency heart rate variability (from 90 to 190 ms2 (p<0.001) and 150 to 300 ms2 (p<0.001), respectively), while low-to-high frequency-ratio was reduced. In addition, the frequency of ventricular ectopic beats increased slightly during cold exposure. The cold induced changes were similar between untreated hypertensive men and controls.ConclusionsShort-term cold exposure with moderate facial and mild whole body cooling resulted in prolongation of T-peak to T-end interval and higher T-wave amplitude while QTc interval was shortened. These changes of ventricular repolarization may have resulted from altered cardiac autonomic regulation and were unaffected by untreated hypertension.Trial RegistrationClinicalTrials.gov NCT02007031

show abstract

“…One report focused on homeless people with hypothermia, who were also alcoholics or drug users. 21 Patients with drug addiction are uncommon in Japan, but there are many such people in other regions such as North and South America and central and western Europe. 22 the 3 groups that were divided on the basis of the severity of hypothermia ( Table 2).…”

Section: J-wave Characteristics and Severity Of Hypothermiamentioning

confidence: 99%

J Waves in Accidental Hypothermia

Higuchi

Takahashi

Kabeya

et al. 2014

Circ J

View full text Add to dashboard Cite

128HIGUCHI S et al. Circulation JournalOfficial Journal of the Japanese Circulation Society http://www. j-circ.or.jp he J wave, also known as the Osborn wave, 1 is a positive deflection at the terminal part of the QRS complex. Although J waves are often observed in hypothermic patients, 2 few reports have revealed the relationship between the presence of J waves and body temperature (BT). The exact BT at which J waves develop in clinical settings has not yet been determined.The J wave is noted not only in hypothermia but also in some nonhypothermic conditions such as Brugada and early repolarization syndromes. The presence of J waves in such syndromes is related to the occurrence of ventricular fibrillation (VF), leading to sudden death. However, whether hypothermic patients with J waves are susceptible to fatal ventricular arrhythmia or ventricular tachycardia (VT)/VF remains undetermined. Indeed, some previous reports have shown that the incidence of VT/VF is unexpectedly low in hypothermic patients with J waves, varying from 0% to 2%. 3-5 The augmentation of J waves following a long R-R interval is reported to be a marker for VF 6,7 because the heterogeneity of membrane potentials is expressed as augmentation of J waves and can induce VF due to phase 2 reentry. 8 A previous report demonstrated that VF developed after sudden augmentation of J waves in idiopathic VF, which was induced following a long coupling interval. 6 Such an event in hypothermic patients would serve as a warning sign for identifying patients at high risk of developing VF.In the present study, we sought to clarify the relationship between the incidence of J waves and BT, as well as the clinical implications of J waves in patients with accidental hypothermia. We also attempted to determine the augmentation of J waves following a long R-R interval in patients with atrial fibrillation (AF). Methods Study DesignWe studied 64 consecutive patients who were admitted to hospital for accidental hypothermia between 2002 and 2012. Of these, 63 were homeless people admitted during the winter. The remaining patient was not homeless, but succumbed to hypothermia in a cold house because of depression. We reviewed all the patients' medical records to evaluate clinical characteristics such as age, sex, vital signs, cause of hypothermia, ECG findings, and laboratory data on admission. Hypothermia was defined as a rectal temperature <35.0°C.

show abstract

Electrocardiographic changes by accidental hypothermia in an urban and a tropical region

Cited by 27 publications

References 26 publications

Hypothermia with Pneumonia: A Rare Presentation of Brucellosis

Hypothermia with Pneumonia: A Rare Presentation of Brucellosis

Cardiac Repolarization and Autonomic Regulation during Short-Term Cold Exposure in Hypertensive Men: An Experimental Study

J Waves in Accidental Hypothermia

Contact Info

Product

Resources

About