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Challenges in Clinical Electrocardiography
Sep 12, 2011

Possible Acute Myocardial Infarction in a Hypothermic Patient—Discussion

Arch Intern Med. 2011;171(16):1431-1432. doi:10.1001/archinternmed.2011.405

After the ECG was obtained, the patient was admitted to the intensive care unit and actively rewarmed with infusions of warm normal saline and administration of a forced-air warming blanket. Serial cardiac biomarkers did not demonstrate evidence of myocardial necrosis (troponin I <0.04 ng/mL [to convert to micrograms per liter, multiply by 1]). After correction of the acidemia (pH 7.35) and rewarming (37.5°C), a repeated ECG 5 hours after the initial presentation demonstrated complete resolution of the previously identified J-point deviation (Figure 2). The patient regained consciousness and was extubated 2 days later.

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