ECG changes in patients with myocarditis are varied. In up to ¼ of patients, ECG findings are normal [97]. According to the references, ECG is important primarily for the exclusion of other pathological states which could explain the patients´ difficulties [8]. There are many ECG changes which may be present like – non-specific repolarisation changes, elevation or depression of ST segment (repolarisation changes may mimic myocardial infarction, picture 10), T wave inversion, prolonged PQ and QT intervals or widened QRS complex, pathological Q wave, lower voltage of QRS complex and ventricular or supraventricular premature beats, bundle branch block, AV block of the 1^st to 3^rd degree and different types of supraventricular and ventricular arrhythmias, which are often presented in GCM, cardiac sarcoidosis and myocarditis caused by B. burgdorferi (in this case it is specifically AV block of the 2^nd or 3^rd degree), [24, 96, 97, 98, 99, 100]. In ICMP, furthermore sings of the left ventricular hypertrophy may be found [99]. Findings of pathological Q-wave, widened QRS complex and prolonged QT interval are connected with the higher risk of death or heart transplant [103].

Picture 10: Diffuse ST elevation in a young male due to myocarditis / pericarditis (author of the picture and description: James Heilman, MD; https://commons.wikimedia.org/wiki/File:PericarditisMyocarditis.jpg?uselang=cs)

Author of the opening picture: Agateller – Anthony Atkielski

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References:

8) ZEMÁNEK D. Kapitola 15: Zánětlivé onemocnění myokardu. In: VESELKA, J. a V.ROHN. Kardiovaskulární medicína [online]. 1. vydání. Brno: Fasta Medica, 2015. ISBN 978-80-88056-00-3.

24) CAFORIO, A.L.P, PANKUWEIT S., ARBUSTINI E., et al. Current state knowledge on aetiology, diagnosis, management, and Therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Disease. European Heart Journal. 2013, 34(-), 2636–2648.

96) Onemocnění myokardu: Myokarditida, zánětlivá kardiomyopatie. ECardio.cz [online]. -: -, – [cit. 2017-01-30].

97) KUCHYNKA P. Kapitola 8.1. Akutní myokarditida. In: MOŤOVSKÁ, Z. a et al. Novinky v akutní kardiologii. Praha: Mladá fronta, 2016. pp. 292–303. ISBN 978-80-204-3903

98) KINDERMANN, I. a et al. Update on Myocarditis. Journal of the American College of Cardiology. 2012, 59(9), 779-792.

99) KUCHYNKA, P. a et al. Myokarditida a zánětlivá kardiomyopatie. Kapitoly z kardiologie. 2013, 3(-), 87-91.

100) KREJČÍ, J. Myokarditidy a zánětlivé kardiomyopatie. Kardiologická Revue Interní Medicína. 2015, 17(4), 288-294.

103) UKENA, CH. a et al. Prognostic electrocardiographic par ametersin patients with suspected myocarditis. European Journal of Heart Failure [online]. 2011, 13(-), 398-405 [cit. 2017-02-27].