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BMJ Case Rep. 2010; 2010: bcr0220102763.
Published online 2010 September 17. doi:  10.1136/bcr.02.2010.2763
PMCID: PMC3028931
Novel treatment (new drug/intervention; established drug/procedure in new situation)

Successful management of fulminant influenza A subtype H1N1 myocarditis


The outbreak and spread of the new influenza A subtype H1N1 reached pandemic levels during 2009, with greater numbers of cases reported daily and numerous complications described. The present report concerns an atypical manifestation of the disease in a previously healthy middle-aged patient who presented with severe, refractory cardiogenic shock 4 days after being diagnosed as having influenza A. The patient was considered for emergency heart transplant. Successful treatment involved the use of a left ventricular assist device, extracorporeal membrane oxygenation, intravenous immunoglobulin and peramivir as therapeutics and bridging therapies for transplant. This case is a report of H1N1 fulminant myocarditis and illustrates the usefulness of a multidisciplinary approach in the care of these patients.

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