Fatalni ishod fulminantnog miokarditisa izazvanog virusom influence A
Sažetak
Apstrakt
Uvod. Miokarditis je zapaljenje srčanog mišića izazvano velikim brojem različitih agenasa, među kojima su najčešći virusi. Fulminantni miokarditis je rapidno progresivni, životnougrožavajući miokarditis, koji je praćen razvojem kardiogenog šoka. Različiti virusi su česti uzročnici međutim, u litaruri je, prema našem znanju, opisano samo nekoliko slučajeva fulminantnog miokarditisa izazvanog influenza A virusom. Prikaz bolesnika. Prikazali smo bolesnika starog 44 godine, primljenog u Jedinicu intenzivne kardiološke nege zbog kliničkih simptoma i elektrokardiografskih znakova koji su pobudili sumnju na akutni infarkt miokarda sa ST elevacijom. Zbog perakutnog razvoja akutne srčane slabosti do nivoa kardiogenog šoka i pored primenjene cirkulatorne potpore došlo je do fatalnog ishoda. Kod bolesnika je urgentnom koronarografijom isključeno postojanje koronarne bolesti, autopsijom dokazano prisustvo miokarditisa, a „real-time” metodom lančane reakcije polimeraze prisustvo virusa influenca A (H3) u nazofaringealnom brisu. Zaključak. Fulminantni miokarditis je teško kardiološko oboljenje koje se leči u jedinicama intenzivne nege medikamentnom i mehaničkom cirkulatornom potporom, uz hitno započinjanje antivirusne terapije koje, i pored primenjene terapije ima visoku stopu mortaliteta. Virus influenca A je redak uzročnik fulminantnog miokarditisa koji treba razmotriti pri postavljanju dijagnoze.
Reference
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