US: Fulminant Myocarditis in H1N1 Cases

[indigo girl]

http://crofsblogs.typepad.com/h5n1/2010/02/us-fulminant-myocarditis-in-h1n1-cases.html

We have seen some of the cases in our threads here at allnurses.

The prevalence of myocardial involvement in influenza infection ranges from 0 to 11% depending on the diagnostic criteria used to define myocarditis (4).

Fulminant myocarditis is an uncommon complication, typically diagnosed in association with circulatory collapse or at autopsy in patients with influenza-associated fatal outcomes (5). A few case reports and series (6-8) represent the incidental diagnoses of influenza-associated acute fulminant myocarditis, but the true prevalence remains unknown.

Here we present the first known report of acute myocarditis in pediatric population associated with the present pandemic H1N1 influenza A virus infection. Four cases occurred within a 30-day period, and 3 of them were diagnosed as fulminant myocarditis with fatal or near-fatal outcomes.

[indigo girl]

H1N1 flu can attack the heart

http://www.signonsandiego.com/news/2010/feb/23/h1n1-flu-can-attack-heart/?

Many viruses are known to attack heart muscle tissue, but such invasions from strains of influenza are rare, cardiac specialists said.

The condition, known as myocarditis, occurs when a virus penetrates heart muscles and sets off a defensive response from the body.

As messenger cytokine cells flood into the heart, they activate an army of white blood cells that lay waste to the viruses as well as healthy tissue. The collateral damage can cause the heart to swell, send the pulse racing and short-circuit the delicate electrical system that keeps the organ pumping blood throughout the body.

No one knows how many swine-flu patients have suffered from myocarditis, mainly because doctors don't always recognize the condition. The complication is present in about 10 percent of patients who die from more common strains of influenza A and about 30 percent of fatal cases involving influenza B, Zaki said.

A few clues, including chest pain and an irregular heartbeat, can suggest that flu viruses have moved into the heart, Azimi said. Patients who temporarily recover from the flu and then suddenly start feeling sick again also should be screened for the complication.

One of these cases is documented in the link below, post #60:

https://allnurses.com/pandemic-flu-forum/deaths-students-school-422611-page7.html

[oramar]

I have a friend that just had an implantable defibulator plus pace maker placed in her chest. The cause of her life threatening arrythmias is thought to be a viral infection of the heart as a child. This goes to show you that even if you survive these infections they can come back to haunt you later on in life.