Int J Cardiol. 2010 Nov 5;145(1):e13-6. doi: 10.1016/j.ijcard.2008.12.099. Epub 2009 Jan 23.
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.
间歇性改变心脏轴在房颤和房扑时也很少报道。急性心肌梗死时的间歇性改变心脏轴以及与房颤和急性心肌梗死相关的改变心脏轴也很少报道。急性心肌炎时已有传导系统障碍的描述，并有人提出心肌间质水肿与急性心肌炎时发生的传导障碍有关。通常，在局灶性心肌炎的急性期，水肿位于心室壁的心外膜层，并且不能与壁运动异常的明确证据相关联。在一篇工作中也描述了交替出现的正常和文氏型心搏序列，伴有交替进行性右束支传导阻滞，解释为慢性恰加斯病性心肌炎时房室传导轴的功能性纵向分离。我们报告了 1 例 15 岁意大利男性急性心肌炎时心脏轴改变的病例。该病例关注的是在无壁运动异常的情况下，局灶性心肌炎急性期的心脏轴改变。
