JACC Case Rep. 2026 May 12:108256. doi: 10.1016/j.jaccas.2026.108256. Online ahead of print.
ABSTRACT
CASE SUMMARY: Accidental hypothermia is associated with distinctive electrocardiographic abnormalities that may precede malignant arrhythmias. We report the case of a 31-year-old homeless man admitted for severe hypothermia whose admission electrocardiogram (ECG) showed sinus bradycardia, prominent Osborn (J) waves in inferolateral leads, and marked QT prolongation. No metabolic, toxic, or structural cardiac abnormalities were identified. With active rewarming and supportive care, a progressive and complete normalization of the ECG occurred within 48 hours. This case highlights the diagnostic value, pathophysiology, and reversibility of hypothermia-related ECG findings.
TAKE-HOME MESSAGES: Accidental hypothermia can produce characteristic ECG changes, including prominent Osborn waves and marked QT prolongation. These abnormalities may completely resolve after rewarming in the absence of electrolyte, toxic, or structural cardiac disease.
PMID:42189023 | DOI:10.1016/j.jaccas.2026.108256