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Electrocardiographic findings and myocardial damage in acute myocarditis detected by cardiac magnetic resonance

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Abstract

Delayed-contrast-enhancement (DCE) magnetic resonance imaging (MRI) can identify areas of myocardial damage in patients with acute myocarditis (AM). The aim of this study was to assess the electrocardiographic findings in AM diagnosed by DCE-MRI. Eighty-one patients (72 men, 35 ± 13 years) with AM were prospectively enrolled. All of them underwent MRI and 12-lead-ECG recordings. In the admission electrocardiogram (ECG 1), as well as in that obtained 48 h later (ECG 2), the following parameters were analyzed: rhythm, PR, QRS, and QTc-intervals, intraventricular conduction, abnormal Q waves, ST segment elevation, and T wave inversion. On admission, 77 patients (95%) were in sinus rhythm, while four patients (6%) manifested severe arrhythmias. No difference between ECG 1 and ECG 2 was observed regarding abnormal Q waves, PR, QRS, and QTc-intervals. Electrocardiogram 1 was normal in 26 patients (32%, normal ECG group), and abnormal in 55 patients (68%, abnormal ECG group). ST elevation was found in 46 patients (57%), inverted T wave in seven patients (9%) and left bundle branch block (LBBB) in two patients (3%). Areas of DCE suggesting AM were found in each patient. No relationship concerning the location of the involved region (s) was found between ECG (leads with ST/T abnormalities) and MRI (areas showing DCE). The ECG in AM can either be normal or reflect abnormalities including arrhythmias, LBBB, ST segment elevation, and T wave inversion. The location of myocardial involvement deduced on the basis of ECG leads showing ST/T changes is not in close relationship with the areas of ventricular damage detected by MRI.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Clinical and Experimental Department of Medicine and Pharmacology, University of Messina, Via Consolare Valeria No. 1, 98100, Messina, Italy

    Gianluca Di Bella, Lilia Oreto, Maria Chiara Todaro, Concetta Zito, Scipione Carerj & Giuseppe Oreto

  2. Department of Radiology, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium

    Anca Florian, Carmela Napolitano & Jan Bogaert

  3. Department of Radiological Science, University of Messina, Messina, Italy

    Rocco Donato

  4. Cardiology Unit, Mirano Hospital, Venice, Italy

    Sara Calamelli

  5. Cardiology Unit, M.G. Vannini Hospital, Rome, Italy

    Giovanni Salvatore Camastra

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  1. Gianluca Di Bella
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  2. Anca Florian
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Correspondence to Gianluca Di Bella.

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Di Bella, G., Florian, A., Oreto, L. et al. Electrocardiographic findings and myocardial damage in acute myocarditis detected by cardiac magnetic resonance. Clin Res Cardiol 101, 617–624 (2012). https://doi.org/10.1007/s00392-012-0433-5

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  • DOI: https://doi.org/10.1007/s00392-012-0433-5

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