Study of cardiac manifestations in patients presenting with dengue infection at a tertiary hospital

 

 

Abstract           Background: Dengue fever has emerged as one of the most important viral disease, associated with mortality. Clinical manifestations of cardiac involvement can vary widely from silent disease to severe myocarditis resulting in death. Present study was aimed to assess the cardiac manifestations of dengue fever and to identify subclinical/ latent cardiac involvement in the disease. Material and Methods: This study was conducted in patients of age > 18 years, either gender, admitted with diagnosis of dengue fever (confirmed with serological test), willing to participate in study. Results: In the present study, 142 patients satisfying inclusion/exclusion criteria were assessed. Majority of the patients were from the age group of 31- 40 years (28.17 %) followed by 41- 50 years of age group (23.24 %). Majority (57.75%) of the patients were male in the current study. As per serology findings, majority of patients were NS1 Positive (47.89%), IgM positive (19.72%) and IgG Positive (13.38%). In present study, 14.79 % were troponin T positive and 17.61 % had significant CK-MB values (> 25). 59.86 % patients had normal ECG, significant ECG findings were Broad ‘QRS’ Complex (10.56%), Diffuse 'T' Wave Inversion (9.86%), Non-Specific 'ST' Segment Changes (9.86%), Sinus Bradycardia (9.15%) and Low Voltage 'QRS' Complex (0.70%). In 92.96 % patients 2D ECHO was normal, significant 2D ECHO findings were anterior wall hypokinesia (2.82%), mild PAH + mild TR + hypokinesia anterior wall (1.41%), mild PAH + mild TR (0.70%), LVH (0.70%), DCM secondary to dengue myocarditis (0.70%) and mild AML prolapse (0.70%). Conclusion: Transient cardiac abnormality, as evidenced by changes in heart rate, rhythm and raised CK MB and troponin I levels in patients with dengue fever are important markers and such patients should undergo thorough evaluation and follow-up even after discharge.

Keywords: Cardiac manifestation; Dengue; NS1 antigen / IgM antibody, myocarditis