Electrocardiogram alterations in acute myocarditis, such as sinus tachycardia and PR segment changes, provide valuable diagnostic and prognostic information for patient management.
What is the diagnostic and prognostic role of electrocardiogram in patients with acute myocarditis?
ECG remains a crucial initial screening tool in acute myocarditis, offering valuable diagnostic clues and prognostic markers to tailor patient management.
BACKGROUND: Acute myocarditis represents a challenging diagnosis as there is no pathognomonic clinical presentation. In patients with myocarditis, electrocardiogram (ECG) can display a variety of non-specific abnormalities. Nevertheless, ECG is widely used as an initial screening tool for myocarditis. METHODS: We researched all possible ECG alterations during acute myocarditis evaluating prevalence, physiopathology, correlation with clinical presentation patterns, role in differential diagnosis, and prognostic yield. RESULTS: The most common ECG abnormality in myocarditis is sinus tachycardia associated with nonspecific ST/T-wave changes. The presence of PR segment depression both in precordial and limb leads, a PR segment depression in leads with ST segment elevation, a PR segment elevation in aVR lead or a ST elevation with pericarditis pattern favor generally diagnosis of perimyocarditis rather than myocardial infarction. In patients with acute myocarditis, features associated with a poorer prognosis are: pathological Q wave, wide QRS complex, QRS/T angle ≥ 100°, prolonged QT interval, high-degree atrioventricular block and malignant ventricular tachyarrhythmia. On the contrary, ST elevation with a typical early repolarization pattern is associated with a better prognosis. CONCLUSIONS: ECG alterations in acute myocarditis could be very useful in clinical practice for a patient-tailored approach in order to decide appropriate therapy, length of hospitalization, and frequency of followup.
Buttà et al. (Thu,) conducted a review in Acute myocarditis. Electrocardiogram (ECG) was evaluated on ECG alterations and their prognostic/diagnostic yield. Electrocardiogram alterations in acute myocarditis, such as sinus tachycardia and PR segment changes, provide valuable diagnostic and prognostic information for patient management.