In viral myocarditis, which electrocardiographic patterns may be observed?

In viral myocarditis, which electrocardiographic patterns may be observed?

• A. Diffuse ST-elevations or heart block
• B. Normal ECG always
• C. No ECG changes
• D. Isolated Q waves only

Answer: (A)

Viral myocarditis can injure the heart muscle and interfere with its electrical signals, producing ECG patterns that reflect both myocardial injury and potential conduction system involvement. A classic pattern you may see is diffuse ST-segment elevations across multiple leads, sometimes with PR-segment depression, which resembles pericarditis. Inflammation can also involve the conduction pathways, leading to varying degrees of heart block. So the combination of diffuse ST elevations and possible heart block captures two common and important ECG manifestations of viral myocarditis. Other options don’t fit as well because ECG changes are not universally normal in this condition, and isolated Q waves are not a typical hallmark of viral myocarditis. While some patients may have non-specific or minimal changes, the described patterns are the ones most commonly observed.

Viral myocarditis can injure the heart muscle and interfere with its electrical signals, producing ECG patterns that reflect both myocardial injury and potential conduction system involvement. A classic pattern you may see is diffuse ST-segment elevations across multiple leads, sometimes with PR-segment depression, which resembles pericarditis. Inflammation can also involve the conduction pathways, leading to varying degrees of heart block. So the combination of diffuse ST elevations and possible heart block captures two common and important ECG manifestations of viral myocarditis.

Other options don’t fit as well because ECG changes are not universally normal in this condition, and isolated Q waves are not a typical hallmark of viral myocarditis. While some patients may have non-specific or minimal changes, the described patterns are the ones most commonly observed.