VizD Answer 3/4/2007

Congratulations to Aaron, he was the first person to submit the correct answer to this week's VizD.

To view Aaron's answers, click here and go to the comments link.

Aaron is the winner of $5.

A 41-year-old man with a known history of ethanol abuse is brought to the emergency department after being found on the street by EMS workers. Upon presentation, the patient's eyes are closed, he is moaning, and does not follow commands. Below is his ECG.

(click on ecg to enlarge)

1. What is the most likely diagnosis given the clinical scenario?
2. Name 3 conditions that can lead to this patient's diagnosis?
3. True or False -- Atropine should be used to increase the heart rate?

Answers:
1. Hypothermia (ECG represents Osborn or J waves, which occur in cases of severe hypothermia. It presents as a large deflection at the end of the QRS complex. The cause of the wave is not known. The colder the patient's core temperature, the higher the Osborn wave)
2. a) low temperature exposure b) sepsis c) Addison's disease d) hypothyroid e) those that Aaron listed
3. False - the hypothermic heart is insensitive to atropine. Warming techniques are the best way to increase the heart rate

The next VizD will be posted on Monday March 5

VizD is a weekly contest of an interesting or pathognomonic image from emergency medicine. Its goal is to integrate learning into a fun and relaxed environment. All images are original and are posted with the consent of the patient. For more information please refer to the following link.