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July 12, 1965

Electrocardiographic Changes in Accidental Hypothermia

Author Affiliations

From the Department of Internal Medicine, Western Montana Clinic, Missoula, Mont (Dr. Reynolds), and Holy Family Hospital, St. Ignatius, Mont (Dr. Van Veen). Dr. Van Veen is currently at Sacred Heart Hospital, Spokane, Wash.

JAMA. 1965;193(2):161-163. doi:10.1001/jama.1965.03090020075025

UNIQUE CHANGES in the electrocardiogram induced by hypothermia have been of interest in recent years. Prior to 1958, only an occasional case of accidental freezing with an ECG taken during hypothermia had been reported. Tomaszewski, cited by Emslie-Smith et al,1 published the first case in 1938, describing an accidentally frozen patient whose ECG showed a slowly inscribed deflection between the QRS complex and the early part of the ST segment. Only eight additional cases had been reported by 1958 when Emslie-Smith described accidental hypothermia and associated electrocardiographic changes in eight elderly patients in Great Britain.2 The ECGs showed a pattern pathognomonic of hypothermia in seven of these eight cases. Since that report by Emslie-Smith, at least 35 subsequent cases of accidental hypothermia have been reported, and all but one of these from Great Britain.3-6 Most of these revealed characteristic electrocardiographic changes. Reports of such cases in the

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