Cardiac involvement in patients of dengue fever in reference to ECG and Echocardiography – A tertiary care center study

Abstract

Introduction: Dengue rarely affects the heart but clinical symptoms of cardiac involvement mayrange greatly from silent illness to severe myocarditis resulting in death. Clinical features areasymptomatic and most are transient among patients with DF/DHF. Material and methods: It wasan observational study conducted at the Department of General Medicine, Peoples College of MedicalSciences and Research Centre, Bhopal. The total duration of the study was One and a half yearsfrom Dec 2018 to May 2020. All dengue patients presenting to People’s Hospital during one and halfyears from which data was collected using as per given proforma. Results: In the present studygroup of 58 patients, it was found that 49 patients (84.5%) have not shown any cardiacabnormalities and 9 patients have abnormal values (15.5%) but are not significant. It is also foundthat the incidence of cardiac manifestations was more common in DHF and dengue shock syndromewhich was 15.5% and 3.4%, respectively. Conclusion: Clinical manifestations of cardiacinvolvement can vary widely from silent disease to severe myocarditis resulting in death. Rhythmabnormalities, hypotension, arrhythmias, myocarditis, myocardial depression with symptoms ofheart failure and shock, and pericarditis have been reported. Involvement of multiple organs, as wellas the presence of metabolic derangement, can further confuse the picture.

Study of cardiac function in adults with dengue

“…and 22.2% of patients had cardiac manifestations respectively. 8,10,11 In the present research, 30/140 (21.4%) patients had cardiac manifestations which are similar to above studies.…”

“…Arora et al, Sukhawani et al and Wali et al reported that 85 (70.83%), 36 (62.1 %) and 70.6 % patients were males. 3,8,9 In the present study, 62.1 % patients were males. This is comparable to above studies.…”

“…The study further reported that rashes, subconjunctival hemorrhage, nose bleeding, gum bleeding and hematemesis were observed in 17 (29.3%), 6 (10.3%), 5 (8.6%), 3 (5.2%), and 2 (3.4%) cases respectively. 8 Wali et al reported that haemorrhagic manifestations were seen in 14 (82.4%) patients. The study further reported that bleeding manifestations included petechiae, gum bleeding, epistaxis, haemoptysis, melaena, and haematemesis in 9 (52.9%), 7 (41.2%), 6 (35.3%), 2 (11.8%), 1 (5.9%), and 3 patients (17.6%) respectively.…”

“…10 Sukhawani et al reported that diastolic dysfunction and pericardial effusion were presented in only 1 (1.7%) cases. 8 Mansanguan et al reported that 3 (3.7%), 3 (3.7%), and 6 (7.4%) patients had left ventricular systolic dysfunction, transient diastolic dysfunction, and small pericardial effusion respectively. The study further reported that myocarditis was suspected in only two DHF patients.…”

“…3 Sukhawani et al reported that the mean age of the patients was 27.9 years. 8 Wali et al reported that the mean age was 29.8 years. 9 In the present study, the mean ± SD of age was 41.6±13.2 years which is higher than the above studies.…”