Stressing Out from the Flu: A Case of Influenza A-associated Transient Cardiomyopathy.

Influenza infections are prevalent and have a large impact on our health system. They are associated with multiorgan complications that can have significant morbidity and mortality. Although influenza is a known etiology of myopericarditis, only a few case reports have documented influenza as a cause of takotsubo cardiomyopathy or stress-induced cardiomyopathy. We present a patient who developed a new left bundle branch block with positive cardiac markers, nonobstructive coronary arteries and a new cardiomyopathy that reversed within 48 hours of diagnosis of influenza A infection. This case highlights a rarer cardiovascular complication of influenza; one that would dictate medication changes, require close follow-up, and have a possibility of recurring.

A Rare Presentation of Nocardia pericarditis Leading to Cardiac Tamponade in an Immunocompetent Patient.

Nocardia can cause isolated disease in many parts of the body including the brain, skin, and lungs. It is also capable of causing disseminated disease. In almost all cases, Nocardia infections occur in immunocompromised hosts with depressed cell-mediated functions. We present a case of disseminated Nocardia farcinica leading to pericardial effusion and tamponade in an immunocompetent host with the only risk factor being heavy alcohol intake. Treatment relies on an accurate diagnosis. This case presentation highlights the importance of considering Nocardia infections in an alcoholic patient with a worsening clinical picture.

Inhalation of 1-1-difluoroethane: A Rare Cause of Pneumopericardium.

We report a case of a 32-year-old man with a past medical history of ethanol use disorder who was brought in unresponsive after inhaling six to 10 cans of the computer cleaning product, Dust-Off. After regaining consciousness, he endorsed severe, pleuritic chest and anterior neck pain. Labs were notable for elevated cardiac enzymes, acute kidney injury, and his initial electrocardiogram (ECG) revealed a partial right bundle branch block with a prolonged corrected QT interval (QTc). On chest X-ray as well as chest computed tomography, the patient was found to have pneumomediastinum, pneumopericardium, and subcutaneous emphysema. The patient's course was uneventful and he was discharged home two days later after extensive substance abuse cessation counseling. Intentionally inhaling toxic substances, also known as "huffing," is a dangerous new trend with significant consequences that clinicians need to be aware of and suspect in young patients presenting with chest pain. We present a rare case of pneumopericardium induced by inhalation of Dust-Off (1-1-difluoroethane).