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J wave

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J wave labelled as Osborn wave. 81-year-old male with BP 80/62 and temperature 31.9 C (89.5 F).
Atrial fibrillation and J wave in a person with hypothermia

A J wave — also known as Osborn wave, camel-hump sign, late delta wave, hathook junction, hypothermic wave,[1] K wave, H wave or current of injury — is an abnormal electrocardiogram finding.[2]


J waves are positive deflections occurring at the junction between the QRS complex and the ST segment,[3][4] where the S point, also known as the J point, has a myocardial infarction-like elevation.

Causes

They are usually observed in people suffering from hypothermia with a temperature of less than 32°C (90°F),[5] though they may also occur in people with high blood levels of calcium (hypercalcemia), brain injury, vasospastic angina, or ventricular fibrillation and could also be a normal variant.

History

The prominent J deflection attributed to hypothermia was first reported in 1938 by Tomaszewski. These waves were then definitively described in 1953 by John J. Osborn (1917–2014) and were named in his honor.[6] Over time, the wave has increasingly been referred to as a J wave, though is still sometimes referred to as the Osborn wave in most part due to Osborn's article in the American Journal of Physiology on experimental hypothermia.[7]

References

  1. ^ Aydin M, Gursurer M, Bayraktaroglu T, Kulah E, Onuk T (2005). "Prominent J wave (Osborn wave) with coincidental hypothermia in a 64-year-old woman". Tex Heart Inst J. 32 (1): 105. PMC 555838. PMID 15902836.
  2. ^ Maruyama M, Kobayashi Y, Kodani E, et al. (2004). "Osborn waves: history and significance". Indian Pacing Electrophysiol J. 4 (1): 33–9. PMC 1501063. PMID 16943886.
  3. ^ "ecg_6lead018.html". Retrieved 2008-12-20.
  4. ^ "THE MERCK MANUAL OF GERIATRICS, Ch. 67, Hyperthermia and Hypothermia, Fig. 67-1". Retrieved 2008-12-20.
  5. ^ Marx, John (2010). Rosen's emergency medicine: concepts and clinical practice 7th edition. Philadelphia, PA: Mosby/Elsevier. p. 1869. ISBN 978-0-323-05472-0.
  6. ^ Osborn JJ. Experimental hypothermia: Respiratory and blood pH changes in relation to cardiac function. Am J Physiol 1953; 175: 389-398.
  7. ^ Serafi S, Vliek C, Taremi M (2011) "Osborn waves in a hypothermic patient" The Journal of Community Hospital Internal Medicine Perspectives http://www.jchimp.net/index.php/jchimp/article/view/10742/html

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