Myocarditis: Differences in Clinical Expression Between Patients with ST Segment Elevation in Electrocardiogram vs Patients Without ST Segment Elevation

Background/Objectives: In case of myocarditis, electrocardiogram (ECG) may suggest the pattern of ST segment elevation myocardial infarction (STEMI) or non-ST segment elevation myocardial infarction (NSTEMI). NSTEMI pattern is less frequent in case of myocarditis, but it remains unclear if presence of ST segment elevation in case of myocarditis is related to more severe condition and more damage in myocardium. Methods: This is a retrospective study, involving 38 patients, admitted with myocarditis. Patients were divided into two groups – patients with ST segment elevation (STE) pattern in ECG (25) and patients without ST segment elevation (non-STE) pattern (13). The data compared were epidemiology, laboratory and instrumental tests results. Data was analysed using IBM SPSS Statistics v26.0. A p value <0,05 was concerned as statistically significant data. Results: C-reactive protein (CRP) levels were higher in STE group (103.40±82.04mg/l vs 43.54±61.93mg/l, p = 0.017). Left ventricle ejection fraction (LVEF) was significantly higher in non-STE pattern group (49.71±4.14 vs 56.58±3.99, p<0.001). Lower LVEF correlates with higher TnI levels (r= -0.353, p=0.032) and higher CRP levels (r = -0.554, p<0.001). Lower left ventricle (LV) strain correlates with higher levels of Troponin I (TnI( (r = -0.641, p = 0.013).Conclusions: LVEF in STE group was lower comparing to non-STE pattern group. STE pattern was associated with higher CRP levels. Higher TnI levels in case of myocarditis were associated with lower LV strain and lower LVEF, higher CRP levels also correlated with lower LVEF. Based by 6 months echocardiographic follow-up – the prognosis of myocarditis is favorable.