Table 1.
Detailed characteristics of 58 patients with myocarditis associated with H1N1pdm2009 influenza.
| Characteristics of 58 patients with H1N1pdm2009 influenza reported in detail | Result (%) |
|---|---|
| Age (mean, years) (range) | 32 (3–72) |
| Less than 17 years (%) | 14 cases (24%) |
| Sex (% female) | 30 cases (52%) |
| Death (%) | 14 cases (24%) |
| Interval between influenza onset and cardiac symptoms (mean, days) (range) | 5.4 (1–21) |
| 1st day to the 3rd day (%) | 51% |
| Cardiac symptoms | |
| Dyspnea (%) | 54% |
| Chest pain (%) | 30% |
| Fulminant myocarditis (%) | 36 cases (62%) |
| Mortality rate of patients with fulminant myocarditis | 39% (14/36) |
| Pneumonia as a complication (%) | 13 cases (22%) |
| ECG findings on the first day of hospitalization | |
| ST elevation (%) | 34% |
| T inversion (%) | 24% |
| Fatal arrhythmias (VF, VT, complete AV block) (%) | 22% |
| Echocardiogram | |
| Diffuse or focal left ventricular wall motion abnormalities | 90% |
| Ejection Fraction (mean ± SD) | 25 ± 11% |
| Percentage of patients in whom CAD was ruled out by CAG | 41% |
| Percentage of adult patients in whom CAD was ruled out by CAG | 64% |
| Treatment | |
| Neuraminidase inhibitors | 85% |
| PCPS | 10 cases (17%) |
| LVAD | 1 case (1.7%) |
| IABP | 11 cases (19%) |
| PCPS or LVAD and/or PCPS | 17 cases (29%) |
| Mortality of patients treated with mechanical support | 23% (4/17) |
| ECMO | 12 cases (21%) |
| Biopsy | 10 cases (17%) |
| Myocarditis with lymphocyte infiltration (mild~moderate) | 6 cases |
| No myocarditis (according to the Dallas criteria) | 4 cases |
| Autopsy | 8 cases (14%) |
| Pachy hemorrhage in the autopsied heart | 3/8 cases (38%) |
| RT-PCR positivity rate for H1N1pdm2009 virus from heart specimens | 4 cases |
ECG: electrocardiogram; VF: ventricular fibrillation; VT: ventricular tachycardia; AV block: atrioventricular block; CAD: coronary artery disease; CAG: coronary angiography; PCPS: percutaneous cardiopulmonary support; LVAD: left ventricular assist device; IABP: intra-aortic balloon pumping; ECMO: extracorporeal membrane oxygenation; RT-PCR: reverse transcription polymerase chain reaction.