tailieunhanh - Báo cáo y học: "Unusual association of ST-T abnormalities, myocarditis and cardiomyopathy with H1N1 influenza in pregnancy: two case reports and review of the literature"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Unusual association of ST-T abnormalities, myocarditis and cardiomyopathy with H1N1 influenza in pregnancy: two case reports and review of the literature. | Chan et al. Journal of Medical Case Reports 2011 5 314 http content 5 1 314 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access Unusual association of ST-T abnormalities myocarditis and cardiomyopathy with H1N1 influenza in pregnancy two case reports and review of the literature Karen Chan1 David Meek1 and Indranil Chakravorty1 2 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 preexisting 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. Introduction Many previous studies have explored the link between influenza and myocarditis. Influenza virus along with Coxsackie B adenovirus echovirus and cytomegalovirus has long