Arbovirus (dengue type) as a cause of acute myocarditis and pericarditis.

Nagaratnam, Nages; Siripala, K; Silva, N de

doi:10.1136/hrt.35.2.204

Cited by 43 publications

(32 citation statements)

References 2 publications

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“…3 Although the incidence of dengue myocarditis is unknown, several cases describing the clinical association between dengue virus and myocarditis have been reported. [4][5][6][7] Most reports of dengue describe patients with 2 or more days of fever, which is consistent with the current classification of dengue. The work by Salgado and others 8 showed direct dengue virus invasion of cardiomyocytes, myocardial interstitial cells, and endothelial cells in a patient who died of myocarditis.…”

Section: Discussionsupporting

confidence: 82%

Myocarditis in a Traveler Returning from the Dominican Republic: An Unusual Presentation of Dengue Fever

Zea¹,

Foley²,

Carey³

2014

The American Journal of Tropical Medicine and Hygiene

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Abstract. Myocarditis is an uncommon manifestation of dengue fever. We describe a case of a 69-year-old Hispanic male who presented to an emergency room in New York City 3 days after returning from a trip to the Dominican Republic complaining of a 1-day history of chest pain and fever. His first electrocardiogram showed a new left bundle branch block, and initial cardiac enzymes included troponin of 5 ng/dL, creatine kinase-MB of 9 ng/mL, and myoglobin of 234 ng/mL. Dengue fever antibodies were found to be elevated: immunoglobulin M (IgM) titer was 2.48 (reference range 0.9), and immunoglobulin G (IgG) titer was 4.26 (reference range 0.9). The patient was diagnosed with myocarditis caused by dengue fever. He improved after 1 week with conservative management in a telemetry unit and was discharged home.

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Section: Discussionsupporting

confidence: 82%

Myocarditis in a Traveler Returning from the Dominican Republic: An Unusual Presentation of Dengue Fever

Zea¹,

Foley²,

Carey³

2014

The American Journal of Tropical Medicine and Hygiene

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“…6,7 Cardiac involvement in dengue has been reported in few studies, usually resulting in a benign and self-limited disease. Although reports of a more severe disease with progression to cardiogenic shock and death have been increasingly described, [8][9][10] the pathogenesis of myocardial lesions has not been elucidated. We present a rare case of a fulminant and fatal myocarditis caused by dengue virus and provide more detailed histological evidence for a possible direct action of dengue virus on myocardial fibres.…”

Section: Introductionmentioning

confidence: 99%

A case presentation of a fatal dengue myocarditis showing evidence for dengue virus-induced lesion

Miranda

Borges

Schmidt

et al. 2013

European Heart Journal: Acute Cardiovascular Care

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Dengue is a prevalent arthropod-borne viral disease in tropical and subtropical areas of the globe. Dengue clinical manifestations include asymptomatic infections; undifferentiated fever; dengue fever, which is characterized by fever, headache, retroorbital pain, myalgia, and arthralgia; and a severe form of the disease denominated dengue haemorrhagic fever/dengue shock syndrome, characterized by haemoconcentration, thrombocytopenia, and bleeding tendency. However, atypical manifestations, such as liver, central nervous system, and cardiac involvement, have been increasingly reported. We report an atypical and rare presentation of dengue disease marked by a dramatic and fatal cardiogenic shock due to acute myocarditis. Histopathological analysis of heart tissue showed several multifocal areas of muscle necrosis and intense interstitial oedema associated with clusters of virus particles inside the cardiomyocytes and in the interstitial space, providing evidence of a possible direct action of dengue virus on myocardium.

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“…Beta-adrenergic blockers, ACE-inhibitors and inotropic support during the crisis are commonly reported in order to maintain hemodynamic stability. Only one case reported the use of prednisolone 21 , but without any other cardiac support drugs, and the outcome was equally poor. Studies on the impact of anti-inflammatory corticosteroids along with cardiovascular support drugs should be carried out, it seems to be a promising option considering the underlying severe systemic inflammatory response in these cases.…”

Section: Resultsmentioning

confidence: 99%

Cardiovascular involvement and manifestations of systemic Chikungunya virus infection: A systematic review

et al. 2017

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Background: In the last three years, chikungunya virus disease has been spreading, affecting particularly the Americas, producing more than two million cases. In this setting, not only new disease-related epidemiological patterns have been found, but also new clinical findings have been reported by different research groups. These include findings on the cardiovascular system, including clinical, electrocardiographic and echocardiographic alterations. Methods: We performed a systematic review looking for reports about cardiovascular compromise during chikungunya disease. Cardiac compromise is not so common in isolated episodes; but countries where chikungunya virus is an epidemic should be well informed about this condition. We used 6 bibliographical databases as resources: Medline/Pubmed, Embase, ScienceDirect, ClinicalKey, Ovid and SciELO. Dengue reports on cardiovascular affectation were included as well, to compare both arbovirus’ organic affectations. Articles that delved mainly into the rheumatic articular and cutaneous complications were not considered, as they were not in line with the purpose of this study. The type of articles included were reviews, meta-analyses, case-controls, cohort studies, case reports and case series. Results: Originally based on 737 articles, our reviewed selected 40 articles with 54.2% at least mentioning CHIKV cardiovascular compromise within the systemic affectation. Cardiovascular manifestations can be considered common and have been reported in France, India, Sri Lanka, Malaysia, Colombia, Venezuela and USA, including mainly, but no limited to: hypotension, shock and circulatory collapse, Raynaud phenomenon, arrhythmias, murmurs, myocarditis, dilated cardiomyopathy, congestive insufficiency, heart failure and altered function profile (Troponins, CPK). Conclusions: Physicians should be encouraged to keep divulgating reports on the cardiovascular involvement of chikungunya virus disease, to raise awareness and ultimately encourage suitable diagnosis and intervention worldwide.

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Arbovirus (dengue type) as a cause of acute myocarditis and pericarditis.

Cited by 43 publications

References 2 publications

Myocarditis in a Traveler Returning from the Dominican Republic: An Unusual Presentation of Dengue Fever

Myocarditis in a Traveler Returning from the Dominican Republic: An Unusual Presentation of Dengue Fever

A case presentation of a fatal dengue myocarditis showing evidence for dengue virus-induced lesion

Cardiovascular involvement and manifestations of systemic Chikungunya virus infection: A systematic review

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