Abstract
The emerging of H7N9 influenza has become an important topic in medicine. 1 Wiwanitkit V. H7N9 influenza: the emerging infectious disease. N Am J Med Sci. 2013; 5: 395-398 Crossref PubMed Scopus (20) Google Scholar This new emerging infection can result in serious clinical outcomes, including death. 1 Wiwanitkit V. H7N9 influenza: the emerging infectious disease. N Am J Med Sci. 2013; 5: 395-398 Crossref PubMed Scopus (20) Google Scholar Apart from general respiratory tract signs and symptoms, other clinical presentations can be seen. Focusing on heart failure, Liu et al noted that one-half of the fatal cases of H7N9 influenza had congestive heart failure. 2 Liu S, Sun J, Cai J, Miao Z, Lu M, Qin S, et al. Epidemiological, clinical and viral characteristics of fatal cases of human avian influenza A (H7N9) virus in Zhejiang Province, China. J Infect. Published online August 16, 2013. Google Scholar This finding is very interesting and implies the requirement for monitoring of heart problems in patients with H7N9 influenza. In fact, heart failure is an important but forgotten problem in emerging influenza. 3 Wiwanitkit V. Heart failure in swine flu: a note. J Card Fail. 2009; 15: 812 Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar Compared with the case of H5N1 influenza, the problem of heart failure in H7N9 influenza is significantly more common. 4 Yu L, Wang Z, Chen Y, Ding W, Jia H, Chan JF, et al. Clinical, virological, and histopathological manifestations of fatal human infections by avian influenza A(H7N9) virus. Clin Infect Dis. Published online August 13, 2013. Google Scholar However, the remaining question is, “What is the pathophysiology of heart failure in H7N9 influenza?” Because there is still no evidence of cardiac pathology in the histologic study of death cases, it is hypothesized that the problem is not due to direct cardiac damage by the H7N9 influenza virus.
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