Title: A Study on Cardiovascular Manifestations of Leptospirosis

Authors: Dr R Legha, Dr Anita SP

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i2.44

Abstract

Background: Leptospirosis is now identified as one of the emerging diseases. It is a very common zoonotic disease across the world, caused by the bacteria of the genus Leptospira, family Leptospiraceae and order Spirochtales2. Clinical manifestations vary from mild to serious or even fatal. Cardiac involvement in leptospirosis is often underestimated. The aim of this study was to throw light on this aspect of the disease.

Materials and Methods: 100 patients who satisfied the inclusion according to the modified Faine`s Criteria were enrolled in the study. They were subjected to a through history and physical examination. Basic investigations were done in all patients, along with ECG, ECHO and cardiac enzyme CK MB. The clinical profile of the disease was studied and the correlation between the outcomes and complication with the ECG and ECHO findings were done.

Observations: 100 patients were enrolled in the study, during the period of 1 year. Majority of the patients were in the age group of 40- 49 years (34%), followed by 24% in the age group of less than 30 years. Mean age group was 43 years. Among the study population 62 were males and 38 were males, with a male to female ratio of 1.63:1. Among the study population, 70% showed ECG changes.  Sinus tachycardia was the commonest ECG change noted(60%).  Those with ECG changes had higher incidence of renal and hepatic imapairement, but no relation with thrombocytopenia. They also had higher incidence of dilalysis and ventilation. Among the ECG changes, it was first degree AV block that was associated with renal impairement, hepatic impairement, dialysis and ventilation. Those with QTc prolongation had higher rates of intervention and poor outcomes like death. Those with ST T changes also had higher degree of renal and hepatic impairement.. Among the 100 patients, ECHO was abnormal in 6 patients Inspite of optimal treatment we had a mortality of 4 %. All those who died had significant changes in ECG, ECHO and renal and hepatic impairment.

References

  1. Harrisons principles of Internal Medicine, 18th Braunwald, Fauci, Kasper, Hauser, Longo, Jameson. The McGraw Hill companies Inc.
  2. KVK text book of Medicine.
  3. Electrocardiographic changes n hospitalized patients with Leptospirosis over a 10 year period. A Kerk v- Med Sci Monit-01-Jul-2011;17(7): CR369-75.
  4. Cardiovascular involvement in Leptospirosis. Indian Heart Journal. 1996;48:691-4.
  5. Cardiovascular changes in leptospirosis, Little flower hospital.
  6. Electrocardiographic changes in Leptospirosis. Malcom Parsons MA, MRCP. Brit Med J. 1965;2:201-203.

Corresponding Author

Dr Anita SP

‘Padmam’ X ray Junction, Cherthala,

Alappuzha District 688524

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