Turrubiates HTA, Álvarez GAD, Guzmán AEM

Language: Spanish
References: 12
Page: 71-74
PDF size: 664.30 Kb.

ABSTRACT

Viral myocarditis is a rare but serious complication associated with viral infections such as dengue. It can lead to severe cardiovascular dysfunction and death. Dengue has a global distribution and presents with a wide range of clinical manifestations, from mild to severe forms, including multiple organ failure and cardiogenic shock. Approximately 5% of dengue cases progress to severe forms, which may involve cardiovascular complications. The following case illustrates an atypical presentation of dengue with fulminant myocarditis, a rare but documented complication that poses diagnostic challenges due to its similarity to acute coronary syndrome. Despite intensive management with vasopressors, inotropes, and mechanical ventilation, the patient experienced progressive clinical deterioration and died due to multiple organ dysfunction and refractory cardiogenic shock. This report highlights the importance of early diagnosis, strict hemodynamic monitoring, and multidisciplinary intervention in the management of complex severe dengue cases. Early recognition of such presentations may improve timely care in endemic areas.

REFERENCES

1. Richardson P, McKenna W, Bristow M, et al. Report of the 1995World Health Organization/International Society and Federationof Cardiology Task Force on the Definition and Classification ofcardiomyopathies. Circulation. 1996;93(5):841-842.

2. Mody KP, Takayama H, Landes E, et al. Acute mechanicalcirculatory support for fulminant myocarditis complicated bycardiogenic shock. J Cardiovasc Transl Res. 2014;7(2):156-164.

3. Olejniczak M, Schwartz M, Webber E, Shaffer A, Perry TE.Viral myocarditis-incidence, diagnosis and management. JCardiothorac Vasc Anesth. 2020;34(6):1591-1601.

4. Kularatne SA, Dalugama C. Dengue infection: Globalimportance, immunopathology and management. Clin Med(Lond). 2022;22(1):9-13.

5. Tejo AM, Hamasaki DT, Menezes LM, Ho YL. Severe dengue inthe intensive care unit. J Intensive Med. 2023;4(1):16-33.

6. Araiza-Garaygordobil D, García-Martínez CE, Burgos LM, et al.Dengue and the heart. Cardiovasc J Afr. 2021;32(5):276-283.

7. Baqi A, Ur Rehman F, Memon PS, Omair SF. Prevalence andoutcomes of myocarditis in dengue-infected patients admittedto a tertiary care Hospital of Low-Middle Income Country. GlobHeart. 2022;17(1):44.

8. Ginsberg F, Parrillo JE. Fulminant myocarditis. Crit Care Clin.2013;29(3):465-483.

9. Burgos LM, Baro Vila RC, Botto F, Diez M. SCAI cardiogenicshock classification for predicting in-hospital and long-termmortality in acute heart failure. J Soc Cardiovasc Angiogr Interv.2022;1(6):100496.

10. Cheng R, Hachamovitch R, Kittleson M, et al. Clinical outcomesin fulminant myocarditis requiring extracorporeal membraneoxygenation: a weighted meta-analysis of 170 patients. J CardFail. 2014;20(6):400-406.

11. Li Y, Hu Z, Huang Y, et al. Characterization of the myocarditisduring the worst outbreak of dengue infection in China. Medicine(Baltimore). 2016;95(27):e4051.

12. Cabrera-Rego JO, Rojas-Quiroz AF, Vidal-Turruelles Y, Yanes-Quintana AA. Manifestaciones cardiovasculares en pacienteshospitalizados con dengue. Enfermedades Infecciosas YMicrobiología Clínica. 2020;39(3):115-118.