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A Study on Cardiac Manifestations of Dengue Fever.

Aims
Incidence of cardiac involvement in dengue fever varies between 15 -50%. Cardiac manifestations of dengue fever include asymptomatic sinus bradycardia, transient AV blocks, transient ventricular arrhythmias, myocarditis and pericardial effusion. This study was done with the objective of finding actual incidence of different cardiac manifestations of dengue fever in our tertiary care hospital.


Methods
One hundred and twenty dengue patients were studied between January 2016 to December 2017. Routine biochemical parameters like complete haemogram, liver function tests, renal function tests, electrolytes were checked in all cases. ECG, echocardiography, Troponin T were evaluated in every patients and they were corroborated with clinical features like chest pain, dyspnoea, palpitation. Patients with electrolyte abnormalities, preexisting heart disease, drugs interfering with heart rhythm were excluded from study.


Results
Fifteen patients had cardiac involvement (12.5%). Eight patient had bradyarrhythmias (6.6%). Asymptomatic sinus bradycardia was commonest (3.3%). All had normal recovery within two weeks. Four patients had left ventricular systolic dysfunction (ejection fraction 35% - 45%) and there was spontaneous recovery within three months. Two patients had pericardial effusion which resolved within two weeks. Transient 2.1 AV block and atrial fibrillation were observed in two cases.


Conclusion
Cardiac manifestations of Dengue were present in 11.4 % of our patents. Brady arrhythmias (6.6%) were commonest manifestation which resolves spontaneously within seven to fourteen days. Left ventricular systolic dysfunction was present in 3.3% of patients which recovered within three months. Pericardial effusion was seen in 2.5% of patients. There were no significant tachyarrhythmias in our patients except one case of atrial fibrillation.