
Persistent Diffuse Deep T-Wave Inversion an ECG Manifestation of Myasthenia Gravis in Crisis: A Case Series
Abstract
Myasthenia gravis (MG) is a disorder with specific autoantibodies directed against the nicotinic acetylcholine receptor (AChR) in the neuromuscular junction. Despite the absence of AChR in the cardiac myocytes, cardiac involvement in MG, ranging from asymptomatic electrocardiogram (ECG) changes to fatal tachyarrhythmias, myocarditis, conduction blocks, heart failure and sudden cardiac death, has been documented in a few case reports. In this case series, we report two cases of MG in crisis presenting with deep diffuse persistent T-wave inversions as markers for possible MG-related cardiac disease.
KEYWORDS: myasthenia gravis, T-wave inversion, electrocardiographic findings.
- Owe JF, Gilhus NE. Myasthenia gravis and the heart. Adv Clin Neurosci Rehabil. 2008;8(5):9-10.
- Câlin C, Savu O, Dumitru D, Ghiorghiu I, Câlin A, Capraru C, Popescu BA, Croitoru M, Vîlciu C, Ginghinâ C. Cardiac involvement in myasthenia gravis – is there a specific pattern? Rom J Intern Med. 2009;47(2):179-89.
- Mygland A, Aarli JA, Hofstad H, Gilhus NE. Heart muscle antibodies in myasthenia gravis. Autoimmunity. 1991;10(4):263-7.
- HooKim K, deRoux S, Igbokwe A, Stanek A, Koo J, Hsu J, Pincus MR, Bluth MH. IgG anti-cardiomyocyte antibodies in giant cell myocarditis. Ann Clin Lab Sci 2008;38(1):83-7.
- Guglin M, Campellone JV, Heintz K, Parillo JE. Cardiac disease in myasthenia gravis: a literature review. J Clin Neuromuscul Dis. 2003; 4:199-203.
- Ashok PP, Ahuja GK, Manchanda SC, Jalal S. Cardiac involvement in myasthenia gravis. Acta Neurol Scand. 1983;68(2):113-20.
Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0
International License, which permits use, share — copy and redistribute the material in any medium or format,
adapt — remix, transform, and build upon the material, as long as you give appropriate credit,
provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner,
but not in any way that suggests the licensor endorses you or your use. You may not use the material for
commercial purposes. If you remix, transform, or build upon the material, you must distribute your
contributions under the same license as the original. You may not apply legal terms or technological
measures that legally restrict others from doing anything the license permits. The images or other
third party material in this article are included in the article’s Creative Commons license, unless indicated
otherwise in a credit line to the material. If material is not included in the article’s Creative Commons
license and your intended use is not permitted by statutory regulation or exceeds the permitted use,
you will need to obtain permission directly from the copyright holder. To view a copy of this license,
visit https://creativecommons.org/licenses/by-nc-sa/4.0/.