Abstract
Background: World Health Organization estimates that 50-100 million dengue infections occur every year with 22000 deaths. The increasing magnitude of the problem together with its changing epidemiology is an important public health concern. The aim of this study was to observe the presence of Electrocardiographic changes in patients of dengue infection and to evaluate whether there were any related clinical cardiac manifestations and correlation of cardiac manifestations to warning signs of dengue.
Methods: This study was conducted at tertiary care institute in department of medicine. Data obtained from 74 patients over the period of one year fulfilling inclusion criteria were studied.
Results: 16 patients had no warning signs, 58 patients had warning signs, out of which 39 patients had two or more warning signs, while 19 patients had single warning sign. Most common warning sign in this study was abdominal pain and Vomiting while Hepatomegaly was the least common warning sign. The most common cardiac abnormalities noted were rhythm abnormalities of which the commonest was sinus bradycardia, found in around 56% of the patients. There was statistically significant correlation between cardiac manifestations and all the warning signs except lethargy/restlessness and Hepatomegaly.
Conclusions: The most common cardiac manifestations noted were transient rhythm abnormalities, of which sinus bradycardia was the commonest. There was statistically significant correlation between cardiac manifestations and all the warning signs except lethargy/restlessness and hepatomegaly.
Keywords: Electrocardiography, dengue infection, cardiac manifestations.
References
- Dengue and dengue haemorrhagic fever. Geneva, World Health Organization. 2008.
- Baruah K, Biswas A, Suneesh K, Dhariwal AC. Dengue fever: Epidemiology and clinical pathogenesis. Chapter 13, Major tropical diseases: Public health perspective. Goa: Broadway publishing House. 2014:255-71.
- Dutta AK, Biswas A, Baruah K, Dhariwal AC. National guidelines for diagnosis and management of dengue fever/dengue hemorrhagic fever and dengue shock syndrome. J Ind Med Assn. 2011;109(1):30-5.
- World Health Organization. Comprehensive guidelines for prevention and control of dengue and dengue hemorrhagic fever. New Delhi: WHO, SEARO; 2011: revised and expanded edition.
- Khoj L, Baksh R, Aslam M, Kelta M, Albeirouti B, Rehman JU. A case of dengue fever-induced severe aplastic anemia salvaged by allogenic bone marrow transplant. J Leuk. 2013;1:1-3.
- Pruthvi D, Shashikala P, Shenoy V. Evaluation of platelet count in dengue fever along with seasonal variation of dengue infection. J Blood Disord Transf. 2012;3:128.
- Alcon S, Talarmin A, Debruyne M, Falconar A, Deubel V, Flamand M. Enzyme-linked immunosorbent assay specific to dengue virus type 1 non-structural protein ns1 reveals circulation of the antigen in the blood during the acute phase of disease in patients experiencing primary or secondary infections. J Clin Microbiol. 2002;40(2):376-81.
- Topley WWC, Wilson SGS. Topley and Wilson Microbiology and Microbial infections, 10th Edition. 2006;993-1009.
- Dengue Cardiac Infection, A Brief Review; Acta Cardiol Sin. 2008;24:226.
- Wichmann D, Kularatne S, Ehrhardt S, Wijesinghe S, Brattig NW, Abel W, 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;40:727-30.
- Sheetal S, Jacob E. A Study on the Cardiac Manifestations of Dengue. JAPI. 2016; 64:30-5.
- Yadav RK, Kumar S. To study cardiac manifestations in patients presenting with dengue infection and to find out the correlation of cardiac manifestations to warning signs of dengue. Int J Adv Med 2017;4:323-8.
- Gubler DJ. Dengue and dengue hemorrhagic fever. Clin Microbiol Rev. 1998;11:480-96.
- Munde DD, Shetkar UB. Clinical features and Hematological Profile of Dengue Fever. Indian J Appl Res. 2013;3:131-2.
- Kumar S, Suman S, Ranjan R. A clinical and biochemical study of dengue fever in Kosi region of Bihar, India. Int J Adv Med 2017;4:964-7.
- Neeraja M, Lakshmi V, Teja VD, Umabala P, Subbalakshmi MV. Serodiagnosis of dengue virus infection in patients presenting to a tertiary care hospital. Indian J Med Microbiol. 2006;24(4):280-2.
- Thein S, Aung MM, Shwe TN, Aye M, Zaw A, Aye K, et al. Risk factors in dengue shock syndrome. Am J Trop Med Hyg. 1997;56:566-72.
- Vishal Kumar Gupta, AK Gadpayle. Subclinical Cardiac Involvement in Dengue Hemorrhagic Fever. JIACM. 2010;11(2):107-11.
Corresponding Author
Dr Tarunendra Kumar Mishra
Department of Medicine, GMCH Ratlam, Madhya Pradesh, India
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
DOI: https://dx.doi.org/10.18535/jmscr/v6i7.166
