Giant Osborn Waves in Hypothermia
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《新英格兰医药杂志》
A 47-year-old man with chronic schizophrenia was hospitalized after prolonged hypothermia. The initial electrocardiogram revealed Osborn waves (arrowheads) similar in amplitude to the R waves. Characteristic sinus bradycardia and prolongation of the QRS interval and the corrected QT interval (QTc) were also noted. During rewarming, the Osborn waves diminished in amplitude, and they disappeared after 24 hours. The baseline tremor artifact caused by shivering (arrows) resolved on normalization of the patient's core body temperature.
In 1953, Dr. John Osborn described the J wave as an "injury current" resulting in ventricular fibrillation during experimental hypothermia. More recent findings suggest that hypothermia increases the epicardial potassium current relative to the current in the endocardium during ventricular repolarization. This transmural voltage gradient is reflected on the surface electrocardiogram as a prominent J, or Osborn, wave. The differential diagnosis of prominent Osborn waves includes early repolarization, hypercalcemia, and the Brugada syndrome.
Mori J. Krantz, M.D.
Christopher M. Lowery, M.D.
Denver Health Medical Center
Denver, CO 80204-4507
In 1953, Dr. John Osborn described the J wave as an "injury current" resulting in ventricular fibrillation during experimental hypothermia. More recent findings suggest that hypothermia increases the epicardial potassium current relative to the current in the endocardium during ventricular repolarization. This transmural voltage gradient is reflected on the surface electrocardiogram as a prominent J, or Osborn, wave. The differential diagnosis of prominent Osborn waves includes early repolarization, hypercalcemia, and the Brugada syndrome.
Mori J. Krantz, M.D.
Christopher M. Lowery, M.D.
Denver Health Medical Center
Denver, CO 80204-4507