Influenza A infection can precipitate life-threatening malignant arrhythmias, including ventricular fibrillation and Torsades de Pointes, even in young, healthy individuals without structural heart disease.
Patients seeking evaluation in the emergency department (ED) for symptoms of an upper respiratory tract infection is a common occurrence. Emergency medicine physicians have adapted to the role of providing advice and therapies for lower-acuity presentations when outpatient services are limited. In most cases, a thorough history and physical examination help guide appropriate testing and subsequent treatment for a possible viral or bacterial etiology. However, it is uncommon for upper respiratory illnesses to present as life-threatening complications. We present a case of a 25-year-old healthy male who initially developed common upper respiratory symptoms, including coughing, subjective fevers, and fatigue. Two days after developing his symptoms, his partner found him unconscious in bed. After Emergency Medical Services (EMS) arrived at the scene, they determined that the patient was in ventricular fibrillation (Vfib) cardiac arrest. The patient’s ED course was complicated by additional episodes of Vfib and pulseless Torsades de Pointes (TdP). Remarkably, testing revealed that he was positive for influenza A. This unique case serves as a reminder that seemingly benign upper respiratory tract infections can still lead to deadly complications, even in young, healthy individuals.
Bandara et al. (Thu,) studied this question.