Prasanth B

Postgraduate Institute of Medical Education and Research, India

Title: Myocardial dysfunction in patients admitted with dengue fever: Report from a tertiary care center in North India


Prasanth B is currently pursuing Residency at the Department of Internal Medicine, PGIMER, Chandigarh, a premier tertiary care centre in North India. Apart from his academic activities, he plays guitar and is also interested in adventure sports.


Introduction: Dengue is endemic in more than 125 countries affecting up to 200 million people per year with India having the maximum burden in Southeast Asia. Myocardial involvement is not an uncommon manifestation in dengue fever and diagnosing it has always been a challenge to the physicians due to its constellation of clinical features and lack of standard screening methods.
Aim: To study the prevalence of myocardial involvement amongst patients with dengue fever.
Methods: Fifty sequential adult patients of dengue fever admitted in our emergency department, PGIMER, Chandigarh, India, were assessed clinically and classified as dengue fever without warning signs, dengue fever with warning signs and severe dengue as per WHO 2012 guidelines. They were studied for possible myocardial involvement by means electrocardiography (ECG), point-of-care testing for cardiac biomarkers (quantitative troponin-I, creatinine kinase-MB Isoform and cardiac myoglobin) and two-dimensional transthoracic echocardiogram (2D-echo).
Results: We found evidence of myocardial involvement in 26%, 16% and 30% patients based on biomarker testing, 2D-echo and ECG respectively. On univariate analysis, presence of cardiac symptoms (p=0.009) and presence of shock (p=0.003) showed statistically significant association with biomarker elevation. However, the three parameters show poor correlation with each other and there is no single parameter, which is associated with clinical severity.
Conclusion: The prevalence of myocardial involvement in dengue varied from 16-30% in our study in which, compared from prior studies, we have used ECG, 2D Echo and Cardiac Biomarkers for evaluation in all the patients.

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