A Study on the Cardiac Manifestations of Dengue.

Objective: This study was done to study the prevalence of cardiac manifestations of dengue fever in patients presenting to our hospital and to find out the correlation of cardiac manifestations to warning signs of dengue and severe dengue.

Methods: The study was conducted at Sree Gokulam Medical College and Research Foundation, which is a tertiary care hospital, in the Department of Medicine in the month of July 2013. One hundred consecutive patients aged 13 years or more with positive dengue serology were interviewed and examined. ECG was done for all patients and selected patients underwent echo evaluation and troponin testing. The data was analyzed using statistical significance tests.

Results: Thirty-three patients had no warning signs, 58 patients had one warning sign or the other. Nine patients had severe dengue. The minimum pulse rate was 34/ minute. The most common cardiac abnormalities noted were rhythm abnormalities of which the commonest was sinus bradycardia, found in 32 percent. There was statistically significant correlation between cardiac manifestations and all the warning signs except persistent vomiting. Among severe dengue, fluid accumulation causing respiratory distress was found to have a significant correlation with the cardiac manifestations.

Conclusions: The most common cardiac manifestations noted were transient rhythm abnormalities, of which sinus bradycardia was the commonest. There was no evidence of myocarditis in any of the patients. There was statistically significant correlation between cardiac manifestations and all the warning signs except persistent vomiting.Among severe dengue, fluid accumulation causing respiratory distress was found to have a significant correlation with the cardiac manifestations.