Osborn wave

Q: J point elevation (Osborn wave) is pathognomonic of hypothermia.

A) True

B) False

Answer: B

J point elevation on EKG (Osborn wave) in hypothermia—found to be most prominent in leads V2 to V5—is overrated! Although it is usually roughly proportional to the degree of hypothermia, it is not pathognomonic for hypothermia. Similar EKG changes can be seen in subarachnoid hemorrhage (SAH), brain injury, patients with early repolarization, hypercalcemia, and Brugada syndrome. 

Also, it is not always present as it requires the ST segment to be unaltered.

#cardiology

References:

1. Graham CA, McNaughton GW, Wyatt JP. The electrocardiogram in hypothermia. Wilderness Environ Med 2001; 12:232.

2. Okada N, Matsuyama T, Morita S, Ehara N, Miyamae N, Okada Y, Jo T, Sumida Y, Watanabe M, Nozawa M, Tsuruoka A, Fujimoto Y, Okumura Y, Hamanaka K, Kitamura T, Nishiyama K, Ohta B. Osborn Wave Is Related to Ventricular Fibrillation and Tachycardia in Hypothermic Patients. Circ J. 2020 Feb 25;84(3):445-455. doi: 10.1253/circj.CJ-19-0856. Epub 2020 Jan 30. PMID: 31996488.

3. Patel A, Getsos JP, Moussa G, Damato AN. The Osborn wave of hypothermia in normothermic patients. Clin Cardiol. 1994 May;17(5):273-6. doi: 10.1002/clc.4960170511. PMID: 8004843.