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Unusual association of ST-T abnormalities, myocarditis and cardiomyopathy with H1N1 influenza in pregnancy: two case reports and review of the literature.

Chan, K; Meek, D; Chakravorty, I (2011) Unusual association of ST-T abnormalities, myocarditis and cardiomyopathy with H1N1 influenza in pregnancy: two case reports and review of the literature. Journal of Medical Case Reports, 5 (314). ISSN 1752-1947 https://doi.org/10.1186/1752-1947-5-314
SGUL Authors: Chakravorty, Indranil

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Abstract

Introduction Myocarditis is rarely reported as an extra-pulmonary manifestation of influenza while pregnancy is a rare cause of cardiomyopathy. Pregnancy was identified as a major risk factor for increased mortality and morbidity due to H1N1 influenza in the pandemic of 2009 to 2010. However, to the best of our knowledge there are no previous reports in the literature linking H1N1 with myocarditis in pregnancy. Case presentation We report the cases of two pregnant Caucasian women (aged 29 and 30), with no pre-existing illness, presenting with respiratory manifestations of H1N1 influenza virus infection in their third trimester. Both women developed evidence of myocarditis. One woman developed acute respiratory distress syndrome, almost reaching the point of requiring extra-corporeal membrane oxygenation, and subsequently developed persistent cardiomyopathy; the other recovered without any long-term consequence. Conclusions While it is not possible to ascertain retrospectively if myocarditis was caused by either infection with H1N1 virus or as a result of pregnancy (in the absence of endomyocardial biopsies), the significant association with myocardial involvement in both women demonstrates the increased risk of exposure to H1N1 influenza virus in pregnant women. This highlights the need for health care providers to increase awareness amongst caregivers to target this 'at risk' group aggressively with vaccination and prompt treatment.

Item Type: Article
Additional Information: © 2011 Chan et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: General & Internal Medicine, 1199 Other Medical And Health Sciences
SGUL Research Institute / Research Centre: Academic Structure > Institute of Medical & Biomedical Education (IMBE)
Academic Structure > Institute of Medical & Biomedical Education (IMBE) > Centre for Clinical Education (INMECE )
Journal or Publication Title: Journal of Medical Case Reports
ISSN: 1752-1947
Related URLs:
Dates:
DateEvent
14 July 2011Published
PubMed ID: 21756329
Web of Science ID: 21756329
Go to PubMed abstract
URI: http://openaccess.sgul.ac.uk/id/eprint/107172
Publisher's version: https://doi.org/10.1186/1752-1947-5-314

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