Cardiovascular manifestations associated with influenza virus infection

Mamas, Mamas A.; Fraser, Doug; Neyses, Ludwig

doi:10.1016/j.ijcard.2008.04.044

Cited by 203 publications

(189 citation statements)

References 48 publications

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“…In the largest case report in children, an infectious myocarditis was implicated in 0.4% of all confirmed influenza cases (6), and 0.97% of adult cases (7). Typically, clinical manifestations are mild and result in uncomplicated cases, but there have been reports of fatal cases from cardiac involvement (8). ECG abnormalities can be seen in up to 45% of individual infected with influenza, including ST deviation, T wave flattening, Q wave formation, and atrial fibrillation (9).…”

Section: Discussionmentioning

confidence: 99%

Influenza H1N1 infection leading to cardiac tamponade in a previously healthy patient: A case report

Bainey¹,

Sidhu²,

Sharma³

et al. 2016

Res Cardiovasc Med

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Introduction: The cardiac manifestations of influenza A are broad, ranging from self-limited pericarditis to fatal cardiomyopathy. The 2009 H1N1 influenza A (H1N1) strain is a rare cause of pericarditis, and its role in developing a pericardial effusion leading to tamponade has infrequently been reported. Case Presentation: We describe a case of a young female with no prior cardiovascular history who presents with a pericardial effusion and shock secondary to cardiac tamponade from pericarditis due to H1N1 influenza A. Conclusions: This case highlights the potential severity of H1N1 infections and the utility of considering cardiac tamponade in patients presenting with influenza symptoms and circulatory collapse.

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Section: Discussionmentioning

confidence: 99%

Influenza H1N1 infection leading to cardiac tamponade in a previously healthy patient: A case report

Bainey¹,

Sidhu²,

Sharma³

et al. 2016

Res Cardiovasc Med

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“…The frequency of myocardial involvement in IVI is variable, with rates as high as 10% (5). Cardiovascular involvement in IVI may result from the direct effects of the virus on the myocardium or exacerbation of existing cardiovascular disease.…”

Section: Discussionmentioning

confidence: 99%

Takotsubo Cardiomyopathy Triggered by Influenza A Virus

et al. 2015

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We herein report the first case of Takotsubo cardiomyopathy triggered by influenza A virus. Myocardial involvement in influenza virus infection has been described in 10% of cases. The literature has principally reported cases of acute myocarditis ranging from asymptomatic to fulminant heart failure and cardiac tamponade. Takotsubo cardiomyopathy frequently occurs in the setting of significant emotional or physical stress or acute medical illness, with a predominance in postmenopausal women. We report the diagnosis, management and outcomes presented in this case, with the aim of describing a new cardiovascular complication of influenza virus infection. Case ReportA 57-year-old woman presented to the emergency department for pulmonary edema requiring oro-tracheal intubation. She had developed hyperthermia with a temperature of 39 2 days prior to presentation. An electrocardiogram showed ST-segment elevation in leads V3, V4 and V5 (Fig. 1). Laboratory testing revealed an increased troponin I-C level (TnI-C: 0.52 μg/mL, n<0.04 μg/mL) and a normal rate of creatine kinase (116 UI/L initially and 113 UI/L the 24 hours later, n<145 UI/L) (Fig. 1). Her medical history consisted of chronic respiratory failure with oxygen dependency in the context of chronic obstructive pulmonary disease and Takotsubo syndrome 10 years previously. There was no information regarding pheochromocytomas or cerebrovascular disease in her history.Because of suspected acute coronary syndrome, the patient was administered aspirin 250 mg and bivalirudin, both intravenously. She developed severe hypotension requiring intravenous administration of norepinephrine. She was transferred to the catheterization laboratory for emergency cardiac coronary angiography, which showed no significant atherosclerosis. The left ventricular angiogram revealed typical apical ballooning (Fig. 2). Echocardiography demonstrated mid-ventricular and apical akinesia with depressed left ventricular function and an estimated ejection fraction of 30%. The patient was monitored using a pulse index continuous cardiac output (PICCO) device and continuous central venous oxygenation (ScVO2) measurements. The first hemodynamic measurement yielded the following results under norepinephrine treatment (2 μg/kg/min): mean arterial pressure (MAP): 65 mmHg; cardiac index (CI): 1.54 L/min/ m 2 ; ScVO2: 55%, cardiac function index: 2 L/min. The lactate level measured was 7 mmol/L with severe metabolic acidosis (pH 7.15). A multidisciplinary discussion precluded the use of extra corporeal membrane oxygenation (ECMO). Therefore, despite the presence of Takotsubo syndrome, 3 μg/kg/min dobutamine was initiated. Under this therapy, the cardiac function and ScVO2 increased, and the peripheral signs of shock disappeared. Eighteen hours later, echocardiography revealed total restoration of ventricular function. The number of eosinophils and other white blood cells were normal during hospitalization. Influenza A (H1N1) virus infection was diagnosed by a nasal rapid influenza diagnostic test...

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“…Pulmonary complications are those most frequently encountered [1][2][3][4]. Extra-pulmonary complications are rare, but can affect numerous organ systems and include cardiac complications such as myocarditis and pericarditis [2].…”

Section: Discussionmentioning

confidence: 99%

“…Extra-pulmonary complications are rare, but can affect numerous organ systems and include cardiac complications such as myocarditis and pericarditis [2]. Neurological sequelae include encephalopathy, encephalitis, transverse myelitis, GuillainBarré syndrome and an increased risk of stroke [5].…”

Section: Discussionmentioning

confidence: 99%

Influenza A‐induced rhabdomyolysis and acute kidney injury complicated by posterior reversible encephalopathy syndrome

Fearnley

Lines²,

Lewington

et al. 2011

Anaesthesia

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SummaryWe report a case of Influenza A‐induced rhabdomyolysis causing acute kidney injury in a young adult female who required invasive ventilation and renal replacement therapy. This case was further complicated by posterior reversible encephalopathy syndrome. Although this represents an extremely rare neurological complication of Influenza A infection, an appreciation of the condition and its management is important, given the high numbers of critically ill patients recently affected by H1N1 Influenza A in intensive care units in the UK.

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Cardiovascular manifestations associated with influenza virus infection

Cited by 203 publications

References 48 publications

Influenza H1N1 infection leading to cardiac tamponade in a previously healthy patient: A case report

Influenza H1N1 infection leading to cardiac tamponade in a previously healthy patient: A case report

Takotsubo Cardiomyopathy Triggered by Influenza A Virus

Influenza A‐induced rhabdomyolysis and acute kidney injury complicated by posterior reversible encephalopathy syndrome

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