Idiopathic Hypothermia

Report:

Sinus bradycardia 46/min

Osborn waves (J waves, hypothermic humps)

Prolonged QT interval 0.65”

QTc 0.57”

Tracing suggests hypothermia.

Comment:

The temperature was 29oC. The only thing missing is evidence of shivering, seen in approximately 90% of ECGs but much smaller percentage of patients clinically.

The cause of the hypothermia remained unknown. The patient had morphologically normal brain on MRI scan. A subtle hypothalamic lesion may not be visible83. He very gradually warmed up, with eventual normalisation of his ECG. The trace taken two days later, still with prolonged QT interval, is shown below (Fig 113a).

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