Cardiac involvement in patients of dengue fever in reference to ECG and Echocardiography – A tertiary care center study

  • Dr. Nitesh Sukhwani Associate Professor, Department of Medicine, PCMS and RC Bhopal, Madhya Pradesh, India
  • Dr. Rohit Chhari Postgraduate student, 3rd year, Department of Medicine, PCMS and RC Bhopal, Madhya Pradesh, India
Keywords: Cardiac manifestations, Dengue, ECG, ECHO


Introduction: Dengue rarely affects the heart but clinical symptoms of cardiac involvement may range greatly from silent illness to severe myocarditis resulting in death. Clinical features are asymptomatic and most are transient among patients with DF/DHF.

Material and methods: It was an observational study conducted at the Department of General Medicine, Peoples College of Medical Sciences and Research Centre, Bhopal. The total duration of the study was One and a half years from Dec 2018 to May 2020. All dengue patients presenting to People’s Hospital during one and half years from which data was collected using as per given proforma.

Results: In the present study group of 58 patients, it was found that 49 patients (84.5%) have not shown any cardiac abnormalities and 9 patients have abnormal values (15.5%) but are not significant. It is also found that the incidence of cardiac manifestations was more common in DHF and dengue shock syndrome which was 15.5% and 3.4%, respectively.

Conclusion: Clinical manifestations of cardiac involvement can vary widely from silent disease to severe myocarditis resulting in death. Rhythm abnormalities, hypotension, arrhythmias, myocarditis, myocardial depression with symptoms of heart failure and shock, and pericarditis have been reported. Involvement of multiple organs, as well as the presence of metabolic derangement, can further confuse the picture.


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Gupta VK, Gadpayle AK. Subclinical cardiac involvement in dengue hemorrhagic fever. Journal, Indian Acad Clin Med. 2010;11(2):107-111.

Wali JP, Biswas A, Chandra S, Malhotra A, Aggarwal P, Handa R, et al. Cardiac involvement in Dengue haemorrhagic fever. Int J Cardiol. 1998;64(1):31-36. doi:10.1016/S0167-5273(98)00008-4.

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(9):e146-e148.

Papalkar P, Sarode R, Acharya S, Kumar S. Cardiac manifestations in dengue. Indian J Med Spec. 2019;10: 30. doi:10.4103/injms.injms_34_18.

Kularatne SAM, Pathirage MMK, Kumarasiri PVR, Gunasena S, Mahindawanse SI. Cardiac complications of a dengue fever outbreak in Sri Lanka, 2005. Trans R Soc Trop Med Hyg. 2007;101(8):804-808. doi:10.1016/j.trstmh.2007.02.021.

Arora M, Patil RS. Cardiac manifestation in dengue fever. J Assoc Physicians India. 2016;64(7):40-44.

Lakshman A, Balasubramanian P, Nampoothiri R V., Vijayvergiya R, Bhalla A, Varma SC. Elevated cardiac biomarkers and echocardiographic left ventricular dysfunction at admission in patients with dengue fever: report from a tertiary care center in Northwest India. Trop Doct. 2018;48(4):261-265. doi: 10.1177/0049475518785315.

Satarasinghe RL, Arultnithy K, Amerasena NL, Bulugahapitiya U, Sahayam D V. Asymptomatic myocardial involvement in acute dengue virus infection in a cohort of adult Sri Lankans admitted to a tertiary referral centre. Br J Cardiol. 2007;14(3):171-173.

Salgado DM, Rodríguez JA, Garzón M, Cifuentes G, Ibarra M, Vega MR, et al. Caracterización clínica y epidemiológica de dengue hemorrágico en Neiva, Colombia, 2004. Rev Salud Publica. 2007;9:53-63. doi:10.1590/S0124-00642007000100006.

Wiwanitkit V. Dengue cardiac infection, a brief review. Acta Cardiologica Sinica. 2008. pp 226–230.

Miranda CH, Borges M de C, Matsuno AK, Vilar FC, Gali LG, Volpe GJ, et al. Evaluation of cardiac involvement during dengue viral infection. Clin Infect Dis. 2013;57(6):812-819. doi:10.1093/cid/cit403.

Singhi S, Kissoon N, Bansal A. Dengue and dengue hemorrhagic fever: management issues in an intensive care unit. J Pediatr (Rio J). 2007;83(2):22-35. doi:10.2223/JPED.1622.

Kohli U, Saharan S, Lodha R, Kabra SK. Persistent thrombocytopenia following dengue shock syndrome. Indian J Pediatr. 2008;75(1):82-83. doi:10.1007/s12098-008-0014-9.

Yusoff H, Roslawati J, Sinniah M, Khalid B. Electrocardiographic and echocardiographic changes during the acute phase of dengue infection in adults. J HK Coll Cardiol. 1993;1: 93-96.

Fernandes AIV, Mendes CL, Simões RH, Silva AEVF, Madruga CB, de Brito CAA, et al. Cardiac tamponade in a patient with severe dengue fever. Rev Soc Bras Med Trop. 2017;50(5):701-705. doi:10.1590/0037-8682-0361-2016.

Deen JL, Harris E, Wills B, Balmaseda A, Hammond SN, Rocha C, et al. The WHO dengue classification and case definitions: time for a reassessment. Lancet. 2006;368(9530):170-173. doi:10.1016/S0140-6736(06)69006-5.

Salgado DM, Eltit JM, Mansfield K, Panqueba C, Castro D, Vega MR, et al. Heart and Skeletal Muscle Are Targets of Dengue Virus Infection. Pediatr Infect Dis J. 2010;29(3):238-242. doi: 10.1097/INF.0b013e3181bc3c5b.

DOI: 10.17511/ijmrr.2020.i06.03
Published: 2020-12-29
How to Cite
Dr. Nitesh Sukhwani, Dr. Rohit Chhari. Cardiac involvement in patients of dengue fever in reference to ECG and Echocardiography – A tertiary care center study. Int J Med Res Rev [Internet]. 2020Dec.29 [cited 2021Jan.23];8(6):392-7. Available from:
Original Article