A 29 years old male patient, chronic smoker with no history of diabetes, hypertension, ischemic heart disease or renal dysfunction was admitted in our hospital with complaints of acute onset pain in the right iliac fossa radiating to the umbilical region associated with multiple episodes of vomiting without hematemesis. Patient was clinically diagnosed to have acute appendicitis and treated for the same.Routine electrocardiogram done in the surgical intensive care unit suggested an acute anterior wall ST segment elevation myocardial infarction for which the patient was thrombolysed. Patients symptoms immediately subsided. Coronary and renal angiogram showed a recanalized left anterior descending artery with right renal artery thrombus. The acute renal infarction was responsible for his acute abdomen. A transient left ventricular clot produced by the stunned myocardium was held responsible for the above events.

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Background: Medical literature has reports of isolated cases of atrioventricular conduction disorders, supraventricular arrhythmias, and myocarditis in dengue fever (DF). There is a paucity of data available in the published literature on the cardiac manifestations of DF from India. The aim of the present study was to assess the cardiac manifestations of DF. Methods: The 140 patients aged ≥18 years with DF confirmed with a serology-dengue non-structural protein 1 antigen-positive were included for this prospective observational study. Three serial ECGs were taken on day one, day three and day seven or day of discharge. All the patients were evaluated using 2D echo on day one, day seven or day of discharge. The primary outcome measures were to find the incidence and type of echocardiographic abnormalities and electrocardiographic changes in dengue.Results: The incidence of cardiac abnormalities on ECG and 2D echo was 30 (21.4%), and 5 (7.0%) respectively. On ECG, 14 (10%) 9 (6.4%) 3 (2.1%) 3 (2.1%) and 1 (0.7%) patients had sinus bradycardia, sinus tachycardia, non-specific ST-T changes, right bundle branch block and atrio-ventricular block on ECG respectively. On 2D echo, 7 (5.0%), 5 (3.6%) and 1 (0.7%) patient had systolic dysfunction, ejection fraction (<45.0%) and diastolic dysfunction respectively.Conclusions: The incidence of cardiac abnormalities on ECG and 2D ECHO in dengue patients was considerable. ECG and 2 D echo should be undertaken in patients with DF.

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