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Submitted by jer5150 on Sun, 09/16/2012 - 10:34

Unfortunately this 12-lead ECG is over 20-years-old, so I have very limited information to go on but this is what I do know about it.

Patient's clinical data:  81-year-old black man with history of Alzheimer's disease (dementia).  The patient's son transported his father via POV to the emergency department's triage room.  Patient had essentially been "failing to thrive" and his presenting blood pressure was hypotensive at 80/62.  Subsequently he was admited to the ICU, intubated, and placed on a ventilator.  He ended up dying about 2 weeks later.

The computer's interpretation was:
Marked sinus bradycardia
Nonspecific intraventricular block

Question:
What probable clinical disorder is this tracing "suggestive of"?  

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Submitted by dr_rshama on Sun, 09/16/2012 - 11:30

 Marked sinus bradycardia with diffuse J wave elevation, long QT and non-specific T wave abnormality should raise the suspicion of hypothermia and hypothyroidism. Some neurological disorders associated with marked J wave elevation as well hypercalcemia, but the later is associated with short QT.

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Submitted by jer5150 on Sat, 09/22/2012 - 10:09

This patient was hypothermic with a temperature of 89.5 F (31.94 C). Classic Osborn waves can be seen in most of the 12 leads.

Jason E. Roediger - Certified Cardiographic Technician (CCT)
[email protected]

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Submitted by jer5150 on Wed, 10/31/2012 - 10:08

To view an alternate kind of Osbourne wave (spelled differently), click on this link.

Jason E. Roediger - Certified Cardiographic Technician (CCT)
[email protected]

Submitted by simor on Tue, 11/13/2012 - 19:34

Now THAT is something you just don't wanna see in any lead ;)

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