The Characteristic Electrocardiogram of Accidental Hypothermia

Abstract

There are few electrocardiographic patterns which are distinctive enough to be considered characteristic of a particular metabolic abnormality. The electrocardiogram of profound accidental hypothermia is, however, frequently diagnostic of that condition. Although the pattern has been previously reported,^1-5it is apparently not well enough known to be immediately recognized. We have recently had experience with an elderly patient who became hypothermic as a result of a cerebrovascular accident and neglect. Her initial ECG was diagnostic of hypothermia, but the abnormalities were not immediately recognized by either the house staff or her attending physicians until a literature search was carried out. Since prompt recognition of this condition and its cardiac effects is essential for the institution of optimal therapy, we present the case history and ECG of our patient to emphasize the diagnostic value of the ECG in this condition. <h3>Patient Summary</h3> A 90-year-old woman was seen in the emergency