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Discordant Electrocardiogram Left Ventricular Wall Thickness and Strain Findings in Influenza Myocarditis
Authors:Nael Hawwa MD  Zoran B Popovic MD  PhD  Hussain A Isma'eel MD
Institution:1. Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio;2. Division of Cardiovascular Medicine, American University of Beirut Medical Center, Beirut, Lebanon
Abstract:A 42‐year‐old man presented with a viral prodrome and tested positive for influenza A. He rapidly deteriorated developing cardiogenic shock, rhabdomyolysis, and acute kidney injury. Patient improved 1 week later with supportive measures including vasopressors, inotropes, and an intraaortic balloon pump. We report this case as it highlights the discordance between echocardiographic ventricular wall thickening as a result of myocardial edema, and electrocardiographic findings at presentation, with a reversal in findings at time of resolution. Additionally, there was some suggestion of a regional pattern to the reduced longitudinal strain.
Keywords:influenza  myocardial edema  longitudinal strain
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