| Influenza Myocarditis and Myositis: Case Presentation and Review of the Literature. | |
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MedLine Citation:
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PMID: 21652168 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Myocarditis, a general inflammatory condition of the heart muscle, can result from a variety of etiologies, the most common being viral. Despite common pathogens, concomitant myocarditis and myositis remains a rare event. Although a common cause of respiratory illness, extrapulmonary infections with influenza are infrequent. We describe the case of a patient who presented to our center with concomitant "seasonal" H1N1 influenza A myocarditis further complicated by pan-myositis. The patient's condition rapidly declined, eventually requiring biventricular mechanical support, in addition to multilimb fasciotomies. The cardiac support required was progressive, from a percutaneous left ventricular assist device, to extracorporeal membrane oxygenation, to eventual biventricular assist device support for bridge-to-transplantation. This case motivated a detailed review of the literature (a total of 29 cases were identified), in which we found that patients with influenza myocarditis/myositis were predominantly female (63%) and young (mean age 33.2 years) and continue to have a high incidence of morbidity and mortality (27%). As a result of its atypical pattern, the 2009 H1N1 pandemic strain has gained attention. From our review, we found 7 patients with of 2009 H1N1 pandemic influenza myocarditis. Serial serum cytokine analysis did not demonstrate a "cytokine storm," which has been associated with other virulent influenza strains. The PB1-F2 marker in particular has been associated with a vigorous cytokine response. The 2009 H1N1 and "seasonal" influenza strains lack this marker. In those patients with community-acquired influenza, interleukin-6 has been shown to correlate with symptoms. For patients with myocarditis resulting in shock, mechanical circulatory support has gained acceptance as a means to recovery or transplantation. |
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Authors:
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Kanwal Kumar; Mina Guirgis; Shelley Zieroth; Evelyn Lo; Alan H Menkis; Rakesh C Arora; Darren H Freed |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-6-6 |
Journal Detail:
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Title: The Canadian journal of cardiology Volume: - ISSN: 1916-7075 ISO Abbreviation: - Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-6-9 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8510280 Medline TA: Can J Cardiol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Institute of Cardiovascular Sciences, St. Boniface Research Centre, Winnipeg, Manitoba, Canada; Department of Surgery, Section of Cardiac Surgery, University of Manitoba, St. Boniface General Hospital Cardiac Sciences Program, Winnipeg, Manitoba, Canada. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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