Key result
In patients with acute myocarditis, total QRS amplitudes in chest leads decreased during the acute stage compared to before illness.
Observational (n=11)
No
Serial ECG findings in acute myocarditis, such as ST elevation without reciprocal depression and transient Q waves, are characteristic and can help differentiate it from acute myocardial infarction.
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QRS amplitude loss may aid myocarditis recognition on serial ECGs; hypothesis-generating and requires validation in larger cohorts.
The purpose of the present study was to clarify the characteristic findings of electrocardiogram (ECG) in 11 patients with acute myocarditis. ST elevation without reciprocal ST depression was one of the conspicuous findings in the acute stage. Total QRS amplitudes at the acute stage were significantly decreased as compared to those before illness and during the convalescent stage. Abnormal Q waves were present in 7 patients and disappeared in a short period. The number of leads showing Q waves was inversely correlated to left ventricular (LV) ejection fraction (r = -0.87, p < 0.01). Conduction disturbances were present in 7 patients. Second degree and advanced AV block was transient while bundle branch block remained over months. Corticosteroid treatment was effective for patients who had edematous myocardial thickening and AV conduction disturbances. As the serial ECG findings in acute myocarditis are so characteristic, and this help to differentiate it from acute myocardial infarction (AMI).
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Nakashima et al. (1994) conducted an observational in Acute myocarditis (n=11). Acute myocarditis vs. Before illness was evaluated on Total QRS amplitude in chest leads (p=<0.01). In patients with acute myocarditis, total QRS amplitudes in chest leads decreased during the acute stage compared to before illness.
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