An elderly patient was found down in her apartment with altered mental status. A prehospital ECG was recorded and was identical to this one:
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| This is pathognomonic of what condition? |
There is slow atrial fibrillation and pronounced J-waves (Osborn waves).
The patient’s temperature was 27 degrees Celsius. There were no electrolyte abnormalities. She was internally rewarmed with an intravascular catheter, treated for a UTI, and did well.
Here is her ECG after rewarming:
Great Tracing and Post. There are clearly Osborn waves in the first ECG. In second ECG, there are misplacement of the limb lead electrodes (LA/LL reversal). Therefore, lead III becomes inverted;
leads I and II switch places; leads aVL and aVF switch places and Lead aVR remains unchanged.Thanks A LOT.