Discordant Electrocardiogram Left Ventricular Wall Thickness and Strain Findings in Influenza Myocarditis

Echocardiography. 2015 Dec;32(12):1880-4. doi: 10.1111/echo.13024. Epub 2015 Aug 1.

Abstract

A 42-year-old man presented with a viral prodrome and tested positive for influenza A. He rapidly deteriorated developing cardiogenic shock, rhabdomyolysis, and acute kidney injury. Patient improved 1 week later with supportive measures including vasopressors, inotropes, and an intraaortic balloon pump. We report this case as it highlights the discordance between echocardiographic ventricular wall thickening as a result of myocardial edema, and electrocardiographic findings at presentation, with a reversal in findings at time of resolution. Additionally, there was some suggestion of a regional pattern to the reduced longitudinal strain.

Keywords: influenza; longitudinal strain; myocardial edema.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Diagnosis, Differential
  • Echocardiography / methods
  • Elastic Modulus
  • Electrocardiography / methods*
  • Heart Ventricles / diagnostic imaging*
  • Heart Ventricles / physiopathology*
  • Humans
  • Influenza, Human / diagnosis*
  • Influenza, Human / physiopathology
  • Male
  • Myocarditis / diagnosis*
  • Myocarditis / physiopathology*