Correlation of cardiac manifestations with severity of dengue fever

 

 

Abstract              Background: Dengue is a serious problem in the tropics. Cardiac involvement is worrisome for both the clinician and patient. Aim: To correlate cardiac manifestations to the severity of dengue fever. Material and Methods: Total 110 confirmed cases of dengue fever by dengue serology were classified according to the World Health Organization criteria into dengue fever (DF), dengue hemorrhagic fever (DHF), and dengue shock syndrome (DSS). The assessment of cardiac manifestations was done based on electrocardiogram (ECG), echocardiogram and cardiac markers. Results: Out of 110 dengue patients, 69.1% had dengue fever, 7.3% had dengue shock syndrome and 23.6% had dengue hemorrhagic fever. On ECG, 59.09% patients had normal sinus rhythm followed by 36.4% had sinus bradycardia. Eight patients were found to have DSS, of which one (0.9%) had pericardial effusion while two (1.8%) had systolic and diastolic dysfunction each. Of the eight patients with DSS, six patients (75%) had positive troponin I and 87.5% had raised CKMB levels. Conclusion: ECG, cardiac enzymes and echocardiography are the main tools to diagnose the myocardial involvement in dengue fever. DHF and DSS cases had higher degree of myocardial involvement as compared to DF cases.

Key Words: Dengue, cardiac, electrocardiography, Echocardiography, markers, severity