ECG Case 074

Rate:

• 30

Rhythm:

• Irregular
• No p waves visible

Axis:

• Normal (+20 deg)

Intervals:

• PR – no p waves visible
• QRS – prolonged (160ms)
• QT – 720-760ms (QTc Bazett 570-600 ms)

Segments:

• Inferior ST sagging

Additional:

• Right bundle branch block
• Terminal QRS Notching – J wave

Interpretation:

• Bradycardia
• Slow atrial fibrillation
• J waves
• QT Prolongation

ECG Findings consistent with hypothermia

Patient’s core temperature was 28°C (82°F)

• ECG Library – Hypothermia
• ECG Library – Osborn Wave (J Wave)
• CCC – Hypothermia
• Eponymictionary – John J Osborn (1917 – 2014)

Further Reading

• Wiesbauer F, Kühn P. ECG Mastery: Yellow Belt online course. Understand ECG basics. Medmastery
• Wiesbauer F, Kühn P. ECG Mastery: Blue Belt online course: Become an ECG expert. Medmastery
• Kühn P, Houghton A. ECG Mastery: Black Belt Workshop. Advanced ECG interpretation. Medmastery
• Rawshani A. Clinical ECG Interpretation ECG Waves
• Smith SW. Dr Smith’s ECG blog.
• Wiesbauer F. Little Black Book of ECG Secrets. Medmastery PDF