Cardiac tamponade and heart failure as a presentation of influenza

A case of influenza A myopericarditis is presented in a patient with cardiac tamponade and immunomediated cardiac failure. Myocarditis is a rare and potentially lethal complication of infection with influenza A, and may manifest with a wide spectrum of cardiac involvement, from mild myocarditis to cardiogenic shock. Even with full supportive therapy, mortality is significant, and normalization of left ventricular function may occur in up to 50% of cases. In the present report, previous literature regarding cardiac involvement following influenza A infection is reviewed, and potential immunological mechanisms involved in the progression of the cardiomyopathy following influenza A infection are discussed. Cardiovascular involvement in influenza infection should be considered in all patients presenting with hemodynamic compromise.