open access

Vol 18, No 4 (2011)
Case Reports
Published online: 2011-07-15
Submitted: 2013-01-14
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Influenza A positive but H1N1 negative myocarditis in a patient coming from a high outbreak region of new influenza

Frank Himmel, Peter Hunold, Heribert Schunkert, Frank Bode
Cardiol J 2011;18(4):441-445.

open access

Vol 18, No 4 (2011)
Case Reports
Published online: 2011-07-15
Submitted: 2013-01-14

Abstract

We present the case of a 21 year-old man holidaying on the Spanish island of Mallorca, a region of high outbreak of infections with a new influenza A/H1N1 virus. Symptomatic influenza A infection, but not H1N1 positive, led to myocarditis after intimate contact with a woman with positive H1N1 titer. The electrocardiogram showed T-wave inversions in II, III, aVF and V5, V6. Serum chemistry showed elevated levels of troponin T, increased creatine kinase (CK) and CK myocardial band. Cardiac magnetic resonance imaging revealed mid- -myocardial and subepicardial hyperintensities in the lateral wall, and subepicardial and mid-myocardial areas of gadolinium enhancement in the inferior wall. Despite intimate contact with an H1N1 positive patient, the analyses on H1N1 (H1 A/Brisbane/59/07, H1 A/ /California/7/09swine) were negative, but were positive for common influenza (H3 A/Brisbane/ /10/07). Myocarditis is a rare clinical manifestation of influenza A infection. (Cardiol J 2011; 18, 4: 441–445)

Abstract

We present the case of a 21 year-old man holidaying on the Spanish island of Mallorca, a region of high outbreak of infections with a new influenza A/H1N1 virus. Symptomatic influenza A infection, but not H1N1 positive, led to myocarditis after intimate contact with a woman with positive H1N1 titer. The electrocardiogram showed T-wave inversions in II, III, aVF and V5, V6. Serum chemistry showed elevated levels of troponin T, increased creatine kinase (CK) and CK myocardial band. Cardiac magnetic resonance imaging revealed mid- -myocardial and subepicardial hyperintensities in the lateral wall, and subepicardial and mid-myocardial areas of gadolinium enhancement in the inferior wall. Despite intimate contact with an H1N1 positive patient, the analyses on H1N1 (H1 A/Brisbane/59/07, H1 A/ /California/7/09swine) were negative, but were positive for common influenza (H3 A/Brisbane/ /10/07). Myocarditis is a rare clinical manifestation of influenza A infection. (Cardiol J 2011; 18, 4: 441–445)
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Keywords

influenza A; H1N1; myocarditis

About this article
Title

Influenza A positive but H1N1 negative myocarditis in a patient coming from a high outbreak region of new influenza

Journal

Cardiology Journal

Issue

Vol 18, No 4 (2011)

Pages

441-445

Published online

2011-07-15

Bibliographic record

Cardiol J 2011;18(4):441-445.

Keywords

influenza A
H1N1
myocarditis

Authors

Frank Himmel
Peter Hunold
Heribert Schunkert
Frank Bode

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