Left ventricular systolic dysfunction in a patient with accidental hypothermia: a case report

IntroductionAccidental hypothermia is a condition associated with significant morbidity and mortality. Hypothermia has been reported to affect left ventricular systolic and diastolic function. However, most of the data come from animal experimental studies.Aim of the studyThe purpose of the present study was to assess the impact of severe accidental hypothermia on systolic and diastolic ventricular function in patients treated using veno-arterial extracorporeal membrane oxygenation (ECMO).MethodsWe prospectively assessed nine hypothermic patients (8 male, age 25–78 years) who were transferred to the Severe Accidental Hypothermia Center and treated with ECMO. Transthoracic echocardiography was performed on admission (in patients without cardiac arrest) and on discharge from ICU after achieving cardiovascular stability. Cardiorespiratory stability and full neurologic recovery was achieved in all patients.ResultsBiomarkers of myocardial damage (CK, CKMB, hsTnT) were significantly elevated in all study patients. Admission echocardiography performed in patients in sinus rhythm, revealed moderate-severe bi-ventricular systolic dysfunction and moderate bi-ventricular diastolic dysfunction. Discharge echocardiography showed persistent mild bi-ventricular diastolic dysfunction, although systolic function of both ventricles returned to normal. Discharge echocardiography in patients admitted with cardiac arrest showed normal (5 patients) or moderately impaired (1 patient) global LV systolic function on discharge. However, mild or moderate LV diastolic dysfunction was observed in all 6 patients. Discharge RV systolic function was normal, whereas mild RV diastolic dysfunction was present in these patients.ConclusionAfter severe accidental hypothermia bi-ventricular diastolic dysfunction persists despite systolic function recovery in survivors treated with ECMO.

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New diastolic cardiomyopathy in patients with severe accidental hypothermia after ECMO rewarming: a case-series observational study

Darocha

Sobczyk

Kosiński

et al. 2015

Cardiovasc Ultrasound

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A Case Report on Osborn Waves of Hypothermia Induced LV Systolic Dysfunction

Singha¹,

Siangshai²,

Lijo³

2021

IJPSRR

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Hypothermia, described as a core body temperature of < 95%, is associated with ECG alteration abnormalities. Sinus bradycardia occurs when the body temperature drops below 90°F, and is correlated with gradual prolongation of the PR interval, QRS complex, QT interval. It can progress to ventricular and atrial fibrillation at a temperature reaching 89°F, which can lead to left ventricular dysfunction. Hypothermia is connected to the osborn waves, which at the end of the QRS complex consist of additional deflection. The inferior and lateral precordial leads are seen by Osborn waves, also known as J waves, Camel hump waves and hypothermic waves. As the body temperature decreases, it becomes more pronounced and a gradual expansion of the QRS complex raises the likelihood of ventricular fibrillation causing ventricle dysfunction.

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Left ventricular systolic dysfunction in a patient with accidental hypothermia: a case report

Cited by 2 publications

References 8 publications

New diastolic cardiomyopathy in patients with severe accidental hypothermia after ECMO rewarming: a case-series observational study

New diastolic cardiomyopathy in patients with severe accidental hypothermia after ECMO rewarming: a case-series observational study

A Case Report on Osborn Waves of Hypothermia Induced LV Systolic Dysfunction

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