Key result
Acute myocarditis patients with Q waves presented with a more severe early illness, including lower left ventricular ejection fraction (40% vs 57%, p<0.001) and higher in-hospital mortality (27% vs 8%).
Why the study?
Does the presence of abnormal Q waves indicate a more severe clinical course in patients with acute myocarditis?
Observational (n=24)
Does the presence of abnormal Q waves indicate a more severe clinical course in patients with acute myocarditis?
The presence of abnormal Q waves in acute myocarditis indicates a more severe early clinical course with greater left ventricular dysfunction and higher rates of cardiogenic shock and conduction disturbances, though long-term prognosis among survivors remains favorable.
Q waves may flag higher early risk in acute myocarditis for closer monitoring; leaves open whether ECG alters management or requires prospective validation.
This study was designed to evaluate the differences in clinical findings between patients with and without Q waves in acute myocarditis. Among a total of 24 patients, eleven patients had Q waves and thirteen did not. Echocardiographic findings, in-hospital complications and follow-up results were compared between the two groups. In the acute stage, the Q wave group showed significantly higher creatine kinase (CK) values and a more impaired left ventricular ejection fraction than the non-Q wave group (40 +/- 11% vs 57 +/- 10%, p < 0.001). Transient left ventricular hypertrophy was also prominent in the Q wave group. The incidence of cardiogenic shock (55%) and conduction disturbances (64%) were higher in the Q wave group than in the non-Q wave group (0% and 15%, respectively). In-hospital mortality rate was 27% in the Q wave group and 8% in the non-Q wave group, respectively. Since rapid improvement occurred in survivors with Q waves, long-term prognosis was favorable for the two groups. In conclusion, Q waves might indicate a more severe course in early illness.
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Nakashima et al. (1998) conducted an observational in Acute myocarditis (n=24). Presence of Q waves vs. Absence of Q waves was evaluated on Left ventricular ejection fraction in the acute stage (p=<0.001). Acute myocarditis patients with Q waves presented with a more severe early illness, including lower left ventricular ejection fraction (40% vs 57%, p<0.001) and higher in-hospital mortality (27% vs 8%).
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