Rivillas JA, González-Jaramillo N, Rocancio-Villamil GE, Thorrens-Ríos JG, Jaramillo-Cataño AN, González-Pérez JM, Lema-Calidonio C

Language: Spanish
References: 13
Page: 565-572
PDF size: 347.99 Kb.

ABSTRACT

Introduction: cardiovascular involvement is an atypical presentation of dengue infection. There range from asymptomatic sinus bradycardia to severe life-threatening myocarditis. Data are lacking regarding epidemiology on this topic. Objective: To describe clinical characteristics of patient’s series with dengue and evidence of cardiovascular involvement. Materials and methods: It was performed a cross-section, observational study of patients admitted with dengue fever in a cardiovascular reference center in Medellín, Colombia during two epidemic viral outbreaks from June 2010 to December 2016. Results: A total of 60 patients were registred, 30% of them with evidence of cardiovascular involvement. Mean age of patients was 63 years old and 55% were male. Most common comorbidity was hypertension (61%, 11/18). Rhythm disturbances affected 72% (13/18) of patients: first grade AV block (46%), sinus bradycardia (38%), atrial fibrillation/flutter/tachycardia (23%) and junctional rhythm (8%). Myocarditis and pericarditis were present in 17% (3/18) and 11% (2/18) of patients, respectively. Other less common findings were left ventricular dysfunction and angor pectoris (11%, 2/18). There were no deaths during the study period. Conclusions: Asymptomatic rhythm disturbances were the most common cardiovascular manifestations of dengue fever and severe forms of cardiovascular dengue were rare. It is recommended to be attentive to the mild symptoms of cardiovascular dysfunction in patients with dengue.

REFERENCES

1. Organización Mundial de la Salud, Organización Panamericana de la Salud. Informe anual de dengue. 2017. Disponible: http://www.paho.org/hq/index. php?option=com_topics&view=readall&cid=3274&Itemi d=40734&lang=es. Consultado: agosto 2017.

2. República de Colombia, Instituto Nacional de Salud, Dirección de Vigilancia y Análisis del Riesgo en Salud Pública. Boletín Epidemiológico Semanal: Semana epidemiológica número 52 de 2016 (25 Diciembre - 31 Diciembre). 2016. Disponible: http://www.ins.gov.co/ buscador-eventos/BoletinEpidemiologico/2016%20 Bolet%C3%ADn%20epidemiol%C3%B3gico%20semana% 2052%20-.pdf. Consultado: agosto 2017.

3. Organización Mundial de la Salud, Organización Panamericana de la Salud, Programa Especial para Investigación y Capacitación en Enfermedades Tropicales (TDR). Dengue: Guías para el diagnóstico, tratamiento, prevención y control. La Paz, Bolivia: OPS/OMS; 2009.

4. Gangasiddaiah N, Nanjundaiah N. Dengue fever: atypical manifestation. Int J Res Med Sci 2017; 2: 1804-1806.

5. Arora M, Patil R.S. Cardiac Manifestation in Dengue Fever. J Assoc Physician India 2016; 64: 40-44.

6. Shivanthan MC, Navinan MR, Constantine GR, Rajapakse S. Cardiac involvement in dengue infection. J Infect Dev Ctries 2015; 9: 338-346.

7. Sheetal S, Jacob E. A Study on the Cardiac Manifestations of Dengue. J Assoc Physicians India 2016; 64: 30-34.

8. Nimmagadda SS, Mahabala C, Boloor A, Raghuram PM, Nayak U A. Atypical Manifestations of Dengue Fever (DF) – Where Do We Stand Today? J Clin Diagn Res 2014; 8: 71-73.

9. Kaushik JS, Gupta P, Rajpal S, Bhatt S. Spontaneous resolution of sinoatrial exit block and atrioventricular dissociation in a child with dengue fever. Singapore Med J 2010; 51: e146-148.

10. Chuah SK. Transient ventricular arrhythmia as a cardiac manifestation in dengue haemorrhagic fever--a case report. Singapore Med J 1987; 28: 569-572.

11. Ku Y-H, Yu W-L. Fatal Dengue Myocarditis despite the Use of Extracorporeal Membrane Oxygenation. Case Rep Infect Dis 2016; 2016: 2.

12. Salazar LA, Schreuder CM, Eslava JA, Murcia AS, Forero MJ, Orozco-Levi MA, et al. Extracorporeal Membrane Oxygenation in Dengue, Malaria, and acute Chagas disease. ASAIO J 2017; 63: e71-e76.

13. Yang T, Chen M, Liang H, Li B, Li J. [Extracorporeal membrane oxygenation for treatment of fulminant myocarditis in patient suffering from dengue fever: a report of 1 case]. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2015; 27: 317-318.