title: Fulminant myocarditis associated with novel H1N1 influenza A.
abstract: Myocarditis secondary to H1N1 influenza has been described in children, but only very rarely in adults. We describe a 36-year-old man with no significant medical history who presented with flu-like symptoms of 3-week duration. When he sought medical attention, he was already manifesting heart failure secondary to fulminant myocarditis, along with multiorgan failure. Despite aggressive management, including circulatory support with a catheter-based mechanical cardiac assist device (Impella 2.5 Cardiac Assist Device, Abiomed, Danvers, MA) as a bridge to cardiac transplant, and aggressive antiviral and antibacterial therapy, the patient died of cardiac arrest. An H1N1 polymerase chain reaction postmortem assay produced positive results, and a diagnosis of fulminant viral myocarditis and multiorgan system failure was established.
authors.affiliation: Division of Cardiology, Winthrop University Hospital, Mineola, New York 11501, USA. khouzamrami@yahoo.com
authors.forename: Rami N
authors.initials: RN
authors.lastname: Khouzam
authors.forename: Constantin
authors.initials: C
authors.lastname: Parizianu
authors.forename: Abdul Moiz
authors.initials: AM
authors.lastname: Hafiz
authors.forename: Shalinee
authors.initials: S
authors.lastname: Chawla
authors.forename: Richard
authors.initials: R
authors.lastname: Schwartz
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000998:Antiviral Agents; D006332:Cardiomegaly; D017809:Fatal Outcome; D006323:Heart Arrest; D006333:Heart Failure / Q000209:etiology*; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000150:complications*; D008297:Male; D009102:Multiple Organ Failure; D009205:Myocarditis / Q000150:complications / Q000175:diagnosis / Q000821:virology*
chemical_list: D000900:Anti-Bacterial Agents; D000998:Antiviral Agents