title: A fatal case of acute myocardial infarction following the improvement of influenza A(H1N1)pdm2009-related acute myocarditis.
abstract: A 52-year-old Indian man was hospitalized due to dyspnea and a high fever caused by influenza A(H1N1)pdm2009. Elevated cardiac enzymes, a chest X-ray showing bilateral infiltrative shadows, cardiomegaly and pleural effusion and echocardiography indicating diffuse hypokinesis of the left ventricle suggested cardiac failure due to acute myocarditis. Owing to the administration of combined modality therapy, including steroids and intravenous γ-globulin, the patient's clinical symptoms of influenza completely resolved. However, he suddenly complained of epigastric pain due to acute myocardial infarction and died. This report is an educational case, the results of which suggest that greater attention should be paid to the potential for myocardial infarction even after an influenza virus infection is found to improve.
authors.affiliation: Department of Molecular Microbiology and Immunology, Nagasaki University School of Medicine, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Iwanaga
authors.forename: Shigeki
authors.initials: S
authors.lastname: Nakamura
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Fukuda
authors.forename: Takahiro
authors.initials: T
authors.lastname: Takazono
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Imamura
authors.forename: Koichi
authors.initials: K
authors.lastname: Izumikawa
authors.forename: Katsunori
authors.initials: K
authors.lastname: Yanagihara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Soda
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Tashiro
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kohno
mesh_terms: D004279:DNA, Viral / Q000032:analysis*; D003937:Diagnosis, Differential; D004452:Echocardiography; D004562:Electrocardiography; D017809:Fatal Outcome; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000235:genetics*; D007251:Influenza, Human / Q000150:complications* / Q000175:diagnosis / Q000821:virology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology*; D009205:Myocarditis / Q000150:complications / Q000175:diagnosis / Q000821:virology*; D014057:Tomography, X-Ray Computed
chemical_list: D004279:DNA, Viral