Electrocardiographic changes in hospitalized patients with leptospirosis over a 10-year period

Abstract

SummaryBackgroundThe aim of this study was to investigate the incidence and type of ECG changes in patients with leptospirosis regardless of clinical evidence of cardiac involvement.Material/MethodsA total of 97 patients with serologically confirmed leptospirosis treated at the University Hospital for Infectious Diseases „Dr. Fran Mihaljević‟ in Zagreb, Croatia, were included in this retrospective study. A 12-lead resting ECG was routinely performed in the first 2 days after hospital admission. Thorough past and current medical history was obtained, and careful physical examination and laboratory tests were performed.ResultsAbnormal ECG findings were found in 56 of 97 (58%) patients. Patients with abnormal ECG had significantly elevated values of bilirubin and alanine aminotransferase, lower values of potassium and lower number of platelets, as well as more frequently recorded abnormal chest x-ray. Non-specific ventricular repolarization disturbances were the most common abnormal ECG finding. Other recorded ECG abnormalities were sinus tachycardia, right branch conduction disturbances, low voltage of the QRS complex in standard limb leads, supraventricular and ventricular extrasystoles, intraventricular conduction disturbances, atrioventricular block first-degree and atrial fibrillation. Myopericarditis was identified in 4 patients. Regardless of ECG changes, the most commonly detected infection was with Leptospira interrogans serovar Australis, Leptospira interrogans serovar Saxkoebing and Leptospira kirschneri serovar Grippotyphosa.ConclusionsThe ECG abnormalities are common at the beginning of disease and are possibly caused by the direct effect of leptospires or are the non-specific result of a febrile infection and metabolic and electrolyte abnormalities. New studies are required for better understanding of the mechanism of ECG alterations in leptospirosis.

Pericarditis as a cardiac manifestation of acute leptospirosis

“…In general, cardiac involvements in leptospirosis are rare. [ 18 , 21 ]. However, exact percentages have not been reported so far.…”

Acute Myopericarditis an Uncommon Presentation of Severe Leptospirosis - A Case Report and Literature Review

“…A search was made in Pub Med, with the variables myopericarditis and leptospirosis, and just two case report was found, from Constans and Lucht called [Myopericarditis and atrial fibrillation disclosing leptospirosis septicemia] publicated in 1996 -France [7,8], it is curious that both papers had the same title and were publicated in the same year. A croatic study in 2011 that include 97 patients and studied Electrocardiographic changes in hospitalized patients with leptospirosis over a 10-year period, found just 4 of 97 patients with myopericarditis, but they didn't describe them specifically [9]. Thus, this case is the first ever report of leptospirosis presenting acute myocarditis and pericarditis due to Leptospirosis in Peru, and in the last 20 years around the world.…”

Evidence of cardiac injury and arrhythmias in dogs with acute kidney injury

“…Leptospirosis has been shown to affect the cardiovascular system and has been associated with arrhythmias, increased cTnI concentrations, and myo‐, endo‐, or pericarditis (Mastrorilli et al , Skerk et al ). Given that 75% of the dogs in the present study were diagnosed with leptospirosis, the extent to which myocardial injury was due to AKI itself or to leptospirosis remains unclear.…”