INFLUENZA A - RELATED ACUTE MYOCARDIAL INFARCTION IN AN ELDERLY WITH NO PREVIOUS HISTORY OF CORONARY HEART DISEASE


Kuşoğlu H.

Uluslararası Akademik Geriatri Kongresi, Antalya, Türkiye, 12 - 16 Nisan 2017, ss.103

  • Yayın Türü: Bildiri / Özet Bildiri
  • Basıldığı Şehir: Antalya
  • Basıldığı Ülke: Türkiye
  • Sayfa Sayıları: ss.103

Özet

INFLUENZA A - RELATED ACUTE MYOCARDIAL INFARCTION IN AN ELDERLY WITH NO PREVIOUS HISTORY OF CORONARY HEART DISEASE Hülya Kuşoğlu1, Fahri Fatih Tipi2 1 Acibadem University School of Medicine,ınfectious Diseases And Clinical Microbiology 2 Acibadem Fulya Hospital, Cardiology Introduction: Influenza infection can lead to complications in patients having underlying cardiovascular diseases. There is increasing evidence from studies that Influenza infection is associated with acute myocardial infarction and in patients with known coronary disease Influenza infection can trigger ischemia. Here we present a patient admitted to the hospital with Influenza A infection who had an ischeamic heart attack but did not have a previous history of coronary heart disease. Case presentation :A 72-year-old woman was admitted to the hospital with fever, headache and dry cough present for 2 days. Her past medical history included hypertension and hyperthyroidism. Her physical examination findings were as fever to be 38.9 ºC, blood pressure 140/80 mmHg., a pharyngeal erythema and rare rhonchi were heard by auscultation. Cardiac sounds were normal with a normal sinus rhythm. The laboratory findings on admission were as leukocyte count 5790 with 77.7% neutrophils, hemoglobin 11.4 g/ dl and platelets as 154.000 . Her renal and liver function tests were within the normal range. Influenza antigen testing was reported to be Influenza A positive. No bacterial growth was detected in the blood cultures at the end of 7 days.. Her chest X-ray on admission showed no pulmonary infiltrates. She was diagnosed to have Influenza A and was started to receive oseltamivir antiviral treatment. On her second day of admission during the night she described chest pain, breathing difficulty, numbness over the fingers and a feeling as if falling down. Her blood pressure was measured as 164/90 mmHg and ECG showed a sinus rhythm but nonspecific V1-V3 t-wave changes. Blood testing for troponin I was found to be 0.133 ng/ml . The troponin I was found to be 0.103 ng/dl 6 hours later and normal on the next morning. Her Echocardiography was performed and left ventricular systolic function was found to be normal with EF as 60%, mild mitral and tricuspid valve failure, and mild pulmonary hypertension. She was diagnosed to have non-ST elevation myocardial infarction and was started losartan, enoxaparin, coraspirin, metoprolol, clopidogrel. Her chest pain did not occur again under this treatment. Her antiviral treatment was continued for 5 days and was discharged to have to undergo coronary angiography. She was also advised to receive yearly Influenza vaccinations which she did not have done this Influenza season. Conclusion: Influenza infection can induce ischemic heart attacks although not diagnosed before. Yearly influenza vaccinations in elderly, especially those having cardiovascular diseases, should be done prevent infection which might later be a trigger an ischemic heart attack. Keywords: Influenza A infection, Acute myocardial infarction