Key result
Severe hypothermia can induce prominent Osborn waves and ST segment elevation mimicking a myocardial infarction, which completely resolve upon successful rewarming.
Why the study?
Conditions like hypothermia can mimic STEMI on electrocardiography, and recognizing them is necessary to avoid unnecessary emergent cardiac catheterization and improve treatment outcomes.
Case Report (n=1)
Hypothermia should be recognized as a potential cause of ST segment elevation mimicking STEMI to avoid unnecessary emergent cardiac catheterization.
Hypothermia may mimic STEMI on ECG, warranting diagnostic caution; case report leaves open prospective validation before practice change.
Prompt recognition of ST segment elevation myocardial infarction (STEMI) is critical as it has significant management and outcome implications, often leading to emergent cardiac catheterization for revascularization. However, other conditions such as pulmonary embolism, myocarditis, hyperkalemia, hypercalcemia, hypothermia, drug overdose, septic shock, left bundle branch block, left ventricular aneurysm, pericarditis, Brugada syndrome, and Takotsubo cardiomyopathy can mimic this presentation on electrocardiography (EKG) and need to be recognized to avoid unnecessary procedures and improve treatment outcomes. We report a case of prominent Osborn waves on EKG from significant hypothermia incorrectly labeled as STEMI. We also provide a literature review on EKG manifestations of hypothermia and the mechanism of those changes, the differential diagnoses of ST segment elevation and their management.
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Forlemu et al. (2021) conducted a case report in Hypothermia-induced ST segment elevation (n=1). Hypothermia was evaluated on Electrocardiographic changes (ST segment elevation). Severe hypothermia can induce prominent Osborn waves and ST segment elevation mimicking a myocardial infarction, which completely resolve upon successful rewarming.
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