Key result
A 15-year-old male with influenza B virus infection developed transient myocarditis mimicking acute coronary syndrome, likely caused by endothelial impairment rather than direct myocyte injury.
Case Report (n=1)
No
Influenza B virus infection can cause myocarditis that clinically mimics acute coronary syndrome, likely due to endothelial impairment and microcirculation disturbance.
Alerts clinicians to consider viral myocarditis in adolescents with ACS-like presentations; leaves open endothelial mechanisms in influenza-associated injury.
We present a notable case of a 15-year-old male infected with influenza B virus who showed the clinical manifestations of myocardial ischemia. He was admitted to our hospital with sudden chest pain. He had febrile illness for the past 2 days. Rapid antigen test for influenza revealed positive influenza B virus antigen. The initial electrocardiogram showed elevation of the ST-segments in leads II, II, aVF and reciprocal depression in leads V1 and V2. Serum test showed elevation of creatine kinase and troponin T. Gadlinium-enchanced magnetic resonance imaging, Tl-201 and I-123 beta-methyl-p-iodephenyl-pentadecanoic acid scintigram, coronary angiography revealed no abnormality. Follow-up electrocardiogram showed ST-segment change improvement over the course. Myocarditis associated with influenza B virus seemed to be caused by endothelial impairment and disturbance of microcirculation rather than direct injury to cardiac myocytes.
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Muneuchi et al. (2009) conducted a case report in Myocarditis mimicking acute coronary syndrome following influenza B virus infection (n=1). Zanamivir and isosorbide dinitrate was evaluated. A 15-year-old male with influenza B virus infection developed transient myocarditis mimicking acute coronary syndrome, likely caused by endothelial impairment rather than direct myocyte injury.
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