Atrial flutter complicating severe leptospirosis: a case report

Abstract

Cardiac disturbances are relatively common and electrocardiographic abnormalities may be found in more than 70% of patients with leptospirosis. We report the case of a 68 year-old male with severe leptospirosis who developed atrial flutter. Effective treatment was done with amiodarone. The patient became clinical stable, with complete recovery. Rigorous clinical observation and continuous electrocardiogram (ECG) monitoring may facilitate the identification of rhythm disorders, and thus prevent a probable fatal outcome, in severe cases of leptospirosis.

Cardiac Manifestation involvement in Dengue Infection

“…The most common age group affected in our study was 20-39 years (53%). [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] This is comparable to the study done by Neeraja et al in 2004, in Hyderabad. [18] The mean age in the present study is 30.45 years.…”

“…[21] A diverse range of ECG abnormalities have been reported with dengue, including rate and rhythm abnormalities, heart block, wave form abnormalities, and voltage abnormalities. [22][23][24][25][26][27][28][29][30][31][32][33] Reported rhythm abnormalities include relative bradycardia, [23] sinoatrial block, [24] disorders of atrioventricular conduction (Junctional rhythm), [24,25] second-degree [26] and complete heart block, [22,27] and monomorphic premature ventricular contractions on a background of heart block, [26] atrial flutter, [28] transient [22,29] and persistent [30] atrial fibrillation, self-limiting tachy-brady arrhythmia, [34] sinoatrial block, and uniform ventricular ectopics progressing to ventricular bigeminy. [31] Electrocardiographic features mimicking acute myocardial infarction have also been reported.…”

Magnitude of Cardiac Involvement in Dengue Fever

“…[11] A diverse range of ECG abnormalities have been reported with dengue, including rate and rhythm abnormalities, heart block, wave form abnormalities, and voltage abnormalities. [12][13][14][15][16][17][18][19][20][21][22][23] Reported rhythm abnormalities include relative bradycardia, [13] sinoatrial block, [14] disorders of atrioventricular conduction (Junctional rhythm), [14,15] seconddegree [16] and complete heart block, [12,17] and monomorphic premature ventricular contractions on a background of heart block, [16] atrial flutter, [18] transient [12,19] and persistent [20] atrial fibrillation, self-limiting tachy-brady arrhythmia, [24] sinoatrial block, and uniform ventricular ectopics progressing to ventricular bigeminy. [21] Electrocardiographic features mimicking acute myocardial infarction have also been reported.…”

Cardiac involvement in dengue infection

“…A diverse range of ECG abnormalities have been reported with dengue, including rate and rhythm abnormalities, heart block, wave form abnormalities, and voltage abnormalities [27][28][29][30][31][32][33][34][35][36][37][38][39][40][41]. Reported rhythm abnormalities include relative bradycardia [28], sinoatrial block [29], disorders of atrioventricular conduction (junctional rhythm [29][30][31], second-degree [32] and complete heart block [27,33], and monomorphic premature ventricular contractions on a background of heart block [32]), atrial flutter [34], transient [27,35] and persistent [36] atrial fibrillation, self-limiting tachybrady arrhythmia [37], sinoatrial block, and uniform ventricular ectopics progressing to ventricular bigemini [38]. Electrocardiographic features mimicking acute myocardial infarction have also been reported [40].…”