Acute Viral Myocarditis Due to Influenza H3N2 Infection A Rare Case Report

Introduction Acute myocarditis is a life-threatening condition that can mimic acute coronary syndrome. While viral infections are a common cause, influenza-related myocarditis is relatively rare. This case report highlights a unique presentation of acute viral myocarditis due to Influenza H3N2 infection.

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Case Summary A 16-year-old male presented to the emergency department with chest pain radiating to the back and upper extremities after experiencing flu-like symptoms for two weeks. On admission:

• ECG Findings: Sinus rhythm with ST-segment elevation (0.5 mV in all leads).
• Cardiac Enzymes: Elevated troponin (12.19 ng/mL) and creatine kinase-MB (63.25 U/L).
• Echocardiogram: Normal left ventricular systolic function with an ejection fraction (LVEF) of 68%.
• MRI Results: Late gadolinium enhancement indicating myocarditis with LVEF of 53%.

Serologic analysis confirmed Influenza H3N2 infection, ruling out other possible causes such as bacterial infections or autoimmune conditions. The patient received supportive care and showed significant improvement within 10 days, with normalized cardiac enzyme levels and continued recovery during a 7-month follow-up.

Clinical Implications According to the American Heart Association (AHA), viral myocarditis is often linked to parvovirus B19, while influenza-related cases are less frequent. However, given its ability to mimic acute coronary syndrome, clinicians should maintain a high index of suspicion in young patients presenting with unexplained chest pain post-viral infection.

Read the full study at: https://doi.com/10.29328/journal.jccm.1001039

Key Takeaways

• Influenza H3N2 myocarditis is rare but can present with symptoms similar to a heart attack.
• Early recognition and imaging (ECG, MRI) are crucial for diagnosis.
• Supportive care leads to a good prognosis in most cases.

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