Muñoz B Pilar, Rossel M Víctor
Rev Med Chil. 2014 Sep;142(9):1205-9. doi: 10.4067/S0034-98872014000900016.
We report a 77-year-old female patient who was admitted to the Emergency Department with impairment of consciousness, hypotension, bradycardia and hypothermia. She required endotracheal intubation and transfer to Intensive Care Unit (ICU). Computed tomography of the brain showed no lesions. Electrocardiogram showed abnormalities suggestive of severe hypothermia (bradycardia, marked elevation of J point associated with ST depression, a negative T wave in V2 to V6 and prolongation of QTc), which was confirmed with a pulmonary artery catheter. Myxedema coma, infections and neurological diseases were discarded. The cause of severe hypothermia was unclear, and the probable source was suspected to be accidental. After intensive treatment the patient improved, achieving normalization of electrocardiographic changes, recovery of organic functions and she was discharged home after 22 days.
我们报告一名77岁女性患者，因意识障碍、低血压、心动过缓和体温过低入住急诊科。她需要进行气管插管并转入重症监护病房（ICU）。脑部计算机断层扫描未显示病变。心电图显示异常，提示严重体温过低（心动过缓、J点明显抬高伴ST段压低、V2至V6导联T波倒置以及QTc延长），经肺动脉导管检查得以证实。排除了黏液性水肿昏迷、感染和神经系统疾病。严重体温过低的原因不明，可能来源怀疑是意外情况。经过强化治疗，患者病情好转，心电图变化恢复正常，器官功能恢复，22天后出院回家。
