Intermittent changing axis deviation during acute myocarditis

Abstract

It has been rarely reported intermittent changing axis deviation also during atrial fibrillation and also during atrial flutter. Intermittent changing axis deviation during acute myocardial infarction and changing axis deviation associated with atrial fibrillation and acute myocardial infarction too have been also rarely reported. Conduction system disturbances have been described during acute myocarditis and it has been suggested that myocardial interstitial edema is implicated in the conduction disturbances that occur in acute myocarditis. Usually, edema is located in the epicardial layer of ventricular wall during acute phase of focal myocarditis and it can't be associated with clear evidence of wall motion abnormalities. It has also been described in a work the report of sequences of alternatively normal and Wenckebach beats with alternate and progressive right bundle branch block interpreted as functional longitudinal dissociation in atrioventricular conduction axis during chronic chagasic myocarditis. We present a case of changing axis deviation during acute myocarditis in a 15-year-old Italian man. This case focuses attention on changing axis deviation during acute phase of focal myocarditis in absence of wall motion abnormalities.