One young patient presented heart failure, and viral myocarditis was suspected. The association of influenza with myocarditis is debated [16] , and H1N1 related myocarditis, has rarely been reported [17] . Furthermore, in our patient prolonged pre-hospital hypoxia was present and myocardial hypoxemia damage might have been involved. The patient required inotrope/vasoactive support for several days and eventually recovered fully with normal heart function.