Clinical features comparison of ST segment elevation and non ST segment elevation in adult patients with acute myocarditis

Abstract

Objective ST segment elevation in adult patients with acute myocarditis is rare in adult. The purpose of this study was to report the outcome of ST segment elevation in adult patients with acute myocarditis in our hospital, in order to provide reference for clinical diagnosis and treatment. Methods A retrospective analysis of Beijing Anzhen Hospital during January 2002 to December 2015 for the diagnosis of acute myocarditis were 105 cases , divided into two groups, one group of ST elevation (ST elevation group) total 57 cases, another group of non ST elevation (non ST elevation group) total 48 cases. The clinical features, laboratory examination, treatment and prognosis were compared between the two groups. The composite primary endpoint of major cardiovascular events (MACE) during hospitalization included: mortality, cardiac shock and ventricular fibrillation. Results The average onset age of patients with ST segment elevation group and non ST segment elevation group were similar [ (27.7 ±10.1) years vs.(28.7 ±10.0) years , P=0.603]. There was a significant difference between the two group in patients of heart rate [(89±22)beats/min vs.(80±23)beats/min , P=0.028], systolic blood pressure on admission [(105±17)mmHg vs.( 115±17) mmHg, P=0.003], diastolic blood pressure on admission [(66±11)mmHg vs. (74±11) mmHg, P=0.000], and total number of acute fulminant myocarditis[20(35.1%)vs.7(14.6%), P=0.024)]. ST segment elevation acute myocarditis patients were significantly more at risk for MACE than non ST segment elevation acute myocarditis patients during hospitalization (P=0.04). Conclusion ST segment elevation acute myocarditis has acute onset and rapid progression. The incidence of MACE during hospitalization was significantly high. Mechanical support can be very favourable.ST segment elevation acute myocarditis is associated with excellent short-term prognosis. Key words: Adult; Acute myocarditis; ST segment elevation; Clinical features; Major cardiovascular events; Mortality; Cardiac shock; Ventricular fibrillation