Successful management of fulminant influenza A subtype H1N1 myocarditis.
The outbreak and spread of the new influenza A subtype H1N1 reached pandemic levels during 2009, with greater numbers of cases reported daily and numerous complications described. The present report concerns an atypical manifestation of the disease in a previously healthy middle-aged patient who presented with severe, refractory cardiogenic shock 4 days after being diagnosed as having influenza A. The patient was considered for emergency heart transplant. Successful treatment involved the use of a left ventricular assist device, extracorporeal membrane oxygenation, intravenous immunoglobulin and peramivir as therapeutics and bridging therapies for transplant. This case is a report of H1N1 fulminant myocarditis and illustrates the usefulness of a multidisciplinary approach in the care of these patients.
Department of Anesthesiology, University of Miami, Miami, Florida, USA. cobas@miami.edu
Miguel
M
Cobas
Lilian
L
Abbo
Miguel
M
Santos
Clara
C
Baccini-Jauregui
Si
S
Pham
D000146:Acids, Carbocyclic; D000998:Antiviral Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003517:Cyclopentanes / Q000627:therapeutic use; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006146:Guanidines / Q000627:therapeutic use; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000150:complications* / Q000628:therapy; D008875:Middle Aged; D009205:Myocarditis / Q000209:etiology* / Q000628:therapy; D012770:Shock, Cardiogenic / Q000209:etiology / Q000628:therapy
D000146:Acids, Carbocyclic; D000998:Antiviral Agents; D003517:Cyclopentanes; D006146:Guanidines; D016756:Immunoglobulins, Intravenous; C414210:peramivir