SHM Converge Scientific Abstract ePoster Gallery-Fulminant Myocarditis Related to Influenza Virus

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This case report describes a 41-year-old man with hypertension who presented with six days of flu-like illness and worsening shortness of breath. On arrival, he was hypertensive, tachycardic, diaphoretic, and appeared critically ill. Initial labs showed leukocytosis, acute kidney injury, elevated lactate, and markedly increased troponin. ECG demonstrated a left bundle branch block of unclear chronicity.<br /><br />His condition deteriorated rapidly into pulseless electrical activity arrest, requiring CPR and ICU admission with vasopressor and ventilatory support. Repeat ECG showed ST elevation, and CT imaging revealed extensive thrombosis involving the left ventricle, inferior vena cava, and iliac vein, along with renal infarcts. Echocardiography showed severe biventricular dysfunction with an ejection fraction of 10%, consistent with fulminant myocarditis and cardiogenic shock.<br /><br />He was started on heparin and underwent emergent cardiac catheterization, which showed no obstructive coronary artery disease. An intra-aortic balloon pump was placed, and he was transferred for possible VA-ECMO. Over the following days, he received supportive care for suspected influenza-related myocarditis and improved significantly. He was eventually extubated, the balloon pump was removed, and guideline-directed medical therapy was started.<br /><br />The report emphasizes that influenza can rarely cause fulminant myocarditis, especially in young males, and may progress quickly to shock, cardiac arrest, and thromboembolic complications. Early recognition, mechanical circulatory support, and supportive management are critical and can lead to recovery.

Asset Subtitle

Harpreet Gosal

Meta Tag

Author List Clark McDonough, Harpreet Gosal

Category Clinical Vignettes

Concept Fulminant Myocarditis

Concept Left Ventricular Dysfunction

Concept Cardiogenic Shock

Concept Influenza Infection

Concept Intracardiac Thrombus

Distinguished Non-Finalist

Presenter Organization Hamilton Medical Center

Presenting Author Harpreet Gosal

Track Adult

Keywords

fulminant myocarditis

influenza myocarditis

cardiogenic shock

pulseless electrical activity

thromboembolism

left ventricular thrombosis

intra-aortic balloon pump

VA-ECMO

acute kidney injury

biventricular dysfunction

Fulminant Myocarditis

Left Ventricular Dysfunction

Cardiogenic Shock

Influenza Infection

Intracardiac Thrombus