Cobas Miguel, Abbo Lilian, Santos Miguel, Baccini-Jauregui Clara, Pham Si
Department of Anesthesiology, University of Miami, Miami, Florida, USA.
BMJ Case Rep. 2010 Sep 17;2010:bcr0220102763. doi: 10.1136/bcr.02.2010.2763.
The outbreak and spread of the new influenza A subtype H1N1 reached pandemic levels during 2009, with greater numbers of cases reported daily and numerous complications described. The present report concerns an atypical manifestation of the disease in a previously healthy middle-aged patient who presented with severe, refractory cardiogenic shock 4 days after being diagnosed as having influenza A. The patient was considered for emergency heart transplant. Successful treatment involved the use of a left ventricular assist device, extracorporeal membrane oxygenation, intravenous immunoglobulin and peramivir as therapeutics and bridging therapies for transplant. This case is a report of H1N1 fulminant myocarditis and illustrates the usefulness of a multidisciplinary approach in the care of these patients.
新型甲型H1N1流感的爆发与传播在2009年达到了大流行程度，每日报告的病例数量增多，且出现了大量并发症的描述。本报告涉及一名既往健康的中年患者，该患者在被诊断为甲型流感4天后出现严重的难治性心源性休克，这是该疾病的一种非典型表现。该患者被考虑进行紧急心脏移植。成功的治疗包括使用左心室辅助装置、体外膜肺氧合、静脉注射免疫球蛋白和帕拉米韦作为治疗手段以及移植的过渡治疗。本病例报告了H1N1暴发性心肌炎，并说明了多学科方法在这些患者护理中的实用性。
