Sepsis, Hypothermia, and the Emergence of Osborn Waves: A Case Report

Hypothermia and sepsis are two serious clinical entities with overlapping presentations, both capable of inducing electrocardiogram (ECG) abnormalities. We present a rare case of a 43-year-old male patient with coincident sepsis, acute kidney injury, and profound hypothermia that was complicated by the development of Osborn ( J) waves and conduction abnormalities on the ECG. The patient’s core temperature was gradually restored to normal utilizing both passive and active rewarming techniques, resulting in the disappearance of the Osborn wave. Concurrently, his cognitive state and cardiovascular parameters became stable after intensive sepsis treatment. Osborn waves arise from changes in the action potential and ion channel activity between the epicardium and the endocardium. These phenomena can be detected in several medical circumstances, including hypothermia, sepsis, subarachnoid hemorrhage, Brugada syndrome, and acute coronary syndrome. This case highlights the complexity of the diagnosis and management of such clinical scenarios.