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Possible association of influenza A infection and reverse takotsubo syndrome
  1. Shmuel Golfeyz1,
  2. Takaaki Kobayashi1,
  3. Shunsuke Aoi2 and
  4. Matthew Harrington1
  1. 1 Internal Medicine, Mount Sinai Beth Israel Hospital, New York City, New York, USA
  2. 2 Department of Cardiovascular Diseases, Mount Sinai Beth Israel Hospital, New York City, New York, USA
  1. Correspondence to Dr Shmuel Golfeyz, sgolfeyz{at}


We present a case of reverse takotsubo syndrome (rTS) in a 68-year-old woman who presented with acute chest pain and flu-like symptoms. She was found to have elevated troponin and abnormal ECG. Urgent coronary angiogram revealed non-obstructive mild coronary artery disease of the left anterior descending artery. Left ventriculography demonstrated hypokinesis of the left ventricular base with sparing of the mid-ventricle and apex. Nasal viral PCR was positive for Influenza A. The diagnosis was confirmed with repeat echocardiogram 2 weeks later revealing resolution of regional wall motion abnormalities. rTS is a type of TS, mimicking acute coronary syndrome. It is seen in younger patients and often occurs with intense emotional and physical stress. Though many triggers have been reported, rTS associated with influenza A has not been previously documented.

  • cardiovascular medicine
  • heart failure
  • interventional cardiology
  • cardiovascular system

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  • Contributors SG and TK wrote the first draft of the manuscript. SA and MH critically reviewed and revised the manuscript. All authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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