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Category: Volume 05 Issue 11 November 2017
Hits: 1947

Title: Cardiac Manifestation involvement in Dengue Infection

Authors: Dr Rajiv Girdhar, Dr Yogesh Kothari, Dr Ram Anil Raj, Dr Pandu Rahul, Dr Kumar Kenchappa, Dr Narayan Raju, Dr Prasanth Rai, Dr Chaithra Kodmad

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i11.102

Abstract

Background and Objectives: Dengue is endemic in the tropics, and complications involving organ systems are seen with varying incidence.

The present study was conducted to find out the proportion of dengue fever cases with cardiac involvement.

Materials and Methods: This is a descriptive study. 211 successive dengue fever cases were selected for the study. Appropriate investigations were done.

Results: It was found that a significant number of patients of dengue developed asymptomatic involvement of heart as evidenced by electrocardiography changes, raised cardiac enzymes.

Conclusion: Myocardial involvement in most of the cases was found to be subclinical on 2-D echo.

Keywords: Dengue, Myocardial Involvement.

References

  1. Raheel U, Faheem M, Riaz MN, Kanwal N, Javed F, Zaidi N, Qadri I (2011) Dengue fever in the Indian Subcontinent: an overview. J Infect Dev Ctries 5: 239-247. doi:10.3855/jidc.1017.
  2. Bhatt S, Gething PW, Brady OJ, Messina JP, Farlow AW, Moyes CL, Drake JM, Brownstein JS, Hoen AG, Sankoh O, Myers MF, George DB, Jaenisch T, Wint GR, Simmons CP, Scott TW, Farrar JJ, Hay SI (2013) The global distribution and burden of dengue. Nature 496: 504-507.
  3. Halstead SB (1988) Pathogenesis of dengue: challenges to molecular biology. Science 239: 476-481.
  4. Rajapakse S, Rodrigo C, Rajapakse A (2012) Treatment of dengue fever. Infect Drug Resist 5: 103-112.
  5. World Health Organization (2009) Dengue: Guidelines for Diagnosis, Treat-ment, Prevention & Control. Available: http://whqlibdoc.who.int/publications/2009/9789241547871_eng.pdf. Accessed 20 December 2014.
  6. Sam SS, Omar SF, Teoh BT, Abd-Jamil J, AbuBakar S (2013) Review of Dengue hemorrhagic fever fatal cases seen among adults: a retrospective study. PLoS Negl Trop Dis 7: e2194.
  7. Gulati S, Maheshwari A (2007) Atypical manifestations of dengue. Trop Med Int Health 12: 1087-1095.
  8. Kularatne SA, Gawarammana IB, Kumarasiri PR (2005) Epidemiology, clinical features, laboratory investigations and early diagnosis of dengue fever in adults: a descriptive study in Sri Lanka. Southeast Asian J of Trop Med & Pub Health 36: 686-692.
  9. Mendez A, Gonzalez G (2006) Abnormal clinical manifestations of dengue hemorrhagic fever in children. Biomedica 26: 61-70.
  10. Naresh G, Kulkarni AV, Sinha N, Jhamb N, Gulati S (2008) Dengue hemorrhagic fever complicated with encephalopathy and myocarditis: a case report. J Com Dis 40: 223-224.
  11. Gupta N, Kulkarni AV, Sinha N, Jhamb R, Gulati S (2010) Dengue hemorrhagic fever complicated with encephalopathy and mycocarditis. J Com Dis 42: 297-299.
  12. Obeyesekere I, Hermon Y (1972) Myocar-ditis and cardiomyopathy after arbovirus infections (dengue and chikungunya fever). Brit Heart J 34: 821-827.
  13. Nagaratnam N, Siripala K, de Silva N (1973) Arbovirus (dengue type) as a cause of acute myocarditis and pericarditis. Brit Heart J 35: 204-206.
  14. Obeyesekere I, Hermon Y (1973) Arbovirus heart disease: myocarditis and cardiomyopathy following dengue and chikungunya fever--a follow-up study. Am Heart J 85: 186-194.
  15. Pongpanich B, Kumponpant S (1973) Studies of dengue hemorrhagic fever. V. Hemodynamic studies of clinical shock associated with dengue hemorrhagic fever. J Pediatrics 83: 1073-1077.
  16. Kularatne SA, Pathirage MM, Kumarasiri PV, Gunasena S, Mahindawanse SI (2007) Cardiac complications of a dengue fever outbreak in Sri Lanka, 2005. Trans Royal Soc Trop Med & Hyg 101: 804-808.
  17. Salgado DM, Rodriguez JA, Garzon M, Cifuentes G, Ibarra M, Vega MR, Castro D (2007) Clinical and epidemiological characterisation of dengue haemorrhagic fever in Neiva, Colombia, 2004. Rev Salud Pub 9: 53-63.
  18. Neeraja M, Lakshmi V, Teja VD, Umabala P and Subbalakshmi MV. Serodiagnosis of dengue virus infection in patients presenting to a tertiary care hospital. Indian J Med Microbiol 2006; 24: 280-2.
  19. Vishal Kumar Gupta, AK Gadpayle. Subclinical Cardiac Involvement in Dengue Hemorrhagic Fever. JIACM 2010; 11(2): 107-11.
  20. Dash PK, Saxena P, Abhavankar A, Bhargava R and Jana AM. Emergence of dengue virus type 3 in Northern India. Southeast Asian J Trop Med Public Health 2005; 36: 370-7.
  21. Kularatne SA, Pathirage MM, Kumarasiri PV, et al. Cardiac complications of a dengue fever outbreak in Sri Lanka, 2005. Trans R Soc Trop Med Hyg 2007;101(8):804-8.
  22. Saldarriaga C, Roncancio G, González N, et al. Manifestaciones cardiacas del dengue. Reporte de una serie de casos durante la epidemia colombiana de 2010. Rev Colomb Cardio 2013;20(6):366-9.
  23. Lateef A, Fisher DA, Tambyah PA. Dengue and relative bradycardia. Emerg Inf Dis 2007;13(4):650-1.
  24. Kaushik JS, Gupta P, Rajpal S, et al. Spontaneous resolution of sinoatrial exit block and atrioventricular dissociation in a child with dengue fever. Sing Med J 2010;51(9):e146-8.
  25. Donegani E, Briceno J. Disorders of atrioventricular conduction in patients with hemorrhagic dengue. Minerva Cardioangiolog 1986;34(7-8):477-80.
  26. Khongphatthallayothin A, Chotivitayat-arakorn P, Somchit S, et al. Morbitz type I second degree AV block during recovery from dengue hemorrhagic fever. Southeast Asian J of Trop Med & Pub Health 2000;31(4):642-5.
  27. Kohli U, Sahu J, Lodha R, et al. Invasive nosocomial aspergillosis associated with heart failure and complete heart block following recovery from dengue shock syndrome. Ped Crit Care Med 2007;8(4):389-91.
  28. Silva FT, da Silva GB, Benevides AN, et al. Atrial flutter complicating severe leptospirosis: a case report. Rev Soc Bras Med Trop 2013;46(2):246-8.
  29. HortaVeloso H, Ferreira JA, de Paiva BJM, et al. Acute atrial fibrillation during dengue hemorrhagic fever. Brazil J Inf Dis 2003;7(6):418-22.
  30. Mahmod M, Darul ND, Mokhtar I, et al. Atrial fibrillation as a complication of dengue hemorrhagic fever: non-self-limiting manifestation. Int J Inf Dis 2009;13(5):e316-8.
  31. Chuah SK. Transient ventricular arrhythmia as a cardiac manifestation in dengue haemorrhagic fever--a case report. Sing Med J 1987;28(6):569-72.
  32. La-Orkhun V, Supachokchaiwattana P, Lertsapcharoen P, et al. Spectrum of cardiac rhythm abnormalities and heart rate variability during the convalescent stage of dengue virus infection: a Holter study. An Trop Paed 2011;31(2):123-8.
  33. Lee CH, Teo C, Low AF. Fulminant dengue myocarditis masquerading as acute myocardial infarction. Int J Cardiol 2009;136(3):e69-71.
  34. Lee IK, Lee WH, Liu JW, et al. Acute myocarditis in dengue hemorrhagic fever: a case report and review of cardiac complications in dengue-affected patients. Int J Inf Dis 2010;14(10):e919-22.
  35. Punja M, Mark DG, McCoy JV, et al. Electrocardiographic manifestations of cardiac infectious-inflammatory disorders. Am J Emerg Med 2010;28(3):364-77.
  36. Dengue NS. Dengue hemorrhagic fever. In: Manson’s tropical diseases. 20th edn. London: WB Saunders 1996:712-29.
  37. Ranjit S, Kissoon N, Gandhi D, et al. Early differentiation between dengue and septic shock by comparison of admission hemodynamic, clinical, and laboratory variables: a pilot study. Ped Emerg Care 2007;23(6):368-75.
  38. Promphan W, Sopontammarak S, Pruekprasert P, et al. Dengue myocarditis. Southeast Asian J Trop Med Public Health 2004;35(3):611-3.
  39. Wichmann D, Kularatne S, Ehrhardt S, et al. Cardiac involvement in dengue virus infections during the 2004/2005 dengue fever season in Sri Lanka. Southeast Asian J Trop Med Public Health 2009;40(4):727-30.
  40. Satarasinghe RL, Arultnithy K, Amerasena NL, et al. Asymptomatic myocardial involvement in acute dengue virus infection in a cohort of adult Sri Lankans admitted to a tertiary referral centre. Brit J Cardiol 2007;14:171-3.
  41. Wali JP, Biswas A, Chandra S, et al. Cardiac involvement in dengue haemorr-hagic fever. Int J Cardiol 1998;64(1):31-6.
  42. Miranda CH, Mde BC, Matsuno AK, et al. Evaluation of cardiac involvement during dengue viral infection. Clin Inf Dis 2013;57(6):812-9
  43. Ehrhardt S, Mockenhaupt FP, Anemana SD, et al. High levels of circulating cardiac proteins indicate cardiac impairment in African children with severe plasmodium falciparum malaria. Microbes Infect 2005;7(11-12):1204-10.
  44. Sengupta SP, Nugurwar A, Jaju R, et al. Left ventricular myocardial performance in patients with dengue hemorrhagic fever and thrombocytopenia as assessed by two-dimensional speckle tracking echocardio-graphy. Indian Heart J 2013;65(3):276-82.

Corresponding Author

Dr Rajiv Girdhar

P.G in DM Cardiology

Rajarajeshwari Medical College & Kengeri, Bengaluru