title: Discordant Electrocardiogram Left Ventricular Wall Thickness and Strain Findings in Influenza Myocarditis.
abstract: A 42-year-old man presented with a viral prodrome and tested positive for influenza A. He rapidly deteriorated developing cardiogenic shock, rhabdomyolysis, and acute kidney injury. Patient improved 1 week later with supportive measures including vasopressors, inotropes, and an intraaortic balloon pump. We report this case as it highlights the discordance between echocardiographic ventricular wall thickening as a result of myocardial edema, and electrocardiographic findings at presentation, with a reversal in findings at time of resolution. Additionally, there was some suggestion of a regional pattern to the reduced longitudinal strain.
authors.affiliation: Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Nael
authors.initials: N
authors.lastname: Hawwa
authors.affiliation: Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Zoran B
authors.initials: ZB
authors.lastname: Popovic
authors.affiliation: Division of Cardiovascular Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Hussain A
authors.initials: HA
authors.lastname: Isma'eel
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D004452:Echocardiography / Q000379:methods; D055119:Elastic Modulus; D004562:Electrocardiography / Q000379:methods*; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D007251:Influenza, Human / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D009205:Myocarditis / Q000175:diagnosis* / Q000503:physiopathology*
keywords: influenza; longitudinal strain; myocardial edema