Review Article
Myocarditis Associated with Influenza A H1N1pdm2009
Table 1
Detailed characteristics of 58 patients with myocarditis associated with H1N1pdm2009 influenza.
| Characteristics of 58 patients with H1N1pdm2009 influenza reported in detail | Result (%) |
| Age (mean, years) (range) | 32 (3–72) | Less than 17 years (%) | 14 cases (24%) | Sex (% female) | 30 cases (52%) | Death (%) | 14 cases (24%) | Interval between influenza onset and cardiac symptoms (mean, days) (range) | 5.4 (1–21) | 1st day to the 3rd day (%) | 51% | Cardiac symptoms | | Dyspnea (%) | 54% | Chest pain (%) | 30% | Fulminant myocarditis (%) | 36 cases (62%) | Mortality rate of patients with fulminant myocarditis | 39% (14/36) | Pneumonia as a complication (%) | 13 cases (22%) | ECG findings on the first day of hospitalization | | ST elevation (%) | 34% | T inversion (%) | 24% | Fatal arrhythmias (VF, VT, complete AV block) (%) | 22% | Echocardiogram | | Diffuse or focal left ventricular wall motion abnormalities | 90% | Ejection Fraction (mean ± SD) | 25 ± 11% | Percentage of patients in whom CAD was ruled out by CAG | 41% | Percentage of adult patients in whom CAD was ruled out by CAG | 64% | Treatment | | Neuraminidase inhibitors | 85% | PCPS | 10 cases (17%) | LVAD | 1 case (1.7%) | IABP | 11 cases (19%) | PCPS or LVAD and/or PCPS | 17 cases (29%) | Mortality of patients treated with mechanical support | 23% (4/17) | ECMO | 12 cases (21%) | Biopsy | 10 cases (17%) | Myocarditis with lymphocyte infiltration (mild~moderate) | 6 cases | No myocarditis (according to the Dallas criteria) | 4 cases | Autopsy | 8 cases (14%) | Pachy hemorrhage in the autopsied heart | 3/8 cases (38%) | RT-PCR positivity rate for H1N1pdm2009 virus from heart specimens | 4 cases |
|
|
ECG: electrocardiogram; VF: ventricular fibrillation; VT: ventricular tachycardia; AV block: atrioventricular block; CAD: coronary artery disease; CAG: coronary angiography; PCPS: percutaneous cardiopulmonary support; LVAD: left ventricular assist device; IABP: intra-aortic balloon pumping; ECMO: extracorporeal membrane oxygenation; RT-PCR: reverse transcription polymerase chain reaction.
|