Acute myocardial infarction being the presentation of dengue myocarditis

Patra, Soumya; Bhardwaj, Gaurav; Manohar, Jayadevappa Suranagi; Srinivasa, K; Kharge, Jayashree; Manjunath, Cholenahally Nanjappa

doi:10.1016/j.jcdr.2013.03.001

Cited by 13 publications

(6 citation statements)

References 4 publications

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“…[ 20 ] Patients with a history of myocarditis, myocardial ischemia, myocardial infarction, heart failure, coronary artery disease, rheumatic heart disease, cardiac neurosis, valvular heart disease, and congenital heart disease were excluded. [ 21 – 23 ] Patients with acute and chronic toxicity, autoimmune diseases, renal failure, and pregnant women were also excluded. The study was approved by the local research ethics committee.…”

Section: Methodsmentioning

confidence: 99%

Characterization of the Myocarditis during the worst outbreak of dengue infection in China

Huang²,

Huang

et al. 2016

Medicine

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Myocarditis is a common complication of severe dengue infection. However, data about prevalence and characterization of myocarditis in dengue are still lacking. In 2014, the worst outbreak of dengue in the last two decades in China occurred. In this study, we described the clinical and laboratory diagnostic features of dengue with myocarditis. Totally, 1782 diagnosed dengue patients were admitted from August to October, 2014, all of whom were subjected to electrocardiogram, ultrasound cardiogram, and cardiac enzyme test. About 201 cases of dengue patients were diagnosed with myocarditis and the prevalence of myocarditis in hospitalized dengue was 11.28%. The prevalence of myocarditis in nonsevere dengue with warning signs and severe dengue [NSD(WS+)/SD] and nonsevere dengue without warning signs [NSD(WS–)] was 46.66% and 9.72%, respectively. The NSD(WS+)/SD patients with myocarditis presented with higher incidence of cardiac symptoms, supraventricular tachycardia (14.29% vs. 0%, P < 0.001), atrial fibrillation (25.71% vs. 10.24%, P = 0.019) and heart failure compared with NSD (WS–) patients with myocarditis. About 150 cases of dengue patients without myocarditis in the same period of time in department of Cardiology were recruited as control group. The proportion of NSD(WS+)/SD in dengue patients with and without myocarditis was 17.41% and 2.53%, respectively. Dengue patients with myocarditis experienced longer hospital stay than those without myocarditis (7.17 ± 4.64 vs. 5.98 ± 2.69, P = 0.008). There was no difference between patients with and without myocarditis in the proportion of symptoms, auxiliary methods abnormality, arrhythmia, and heart failure on the discharge day. Our study demonstrates the prevalence of myocarditis in worst outbreak of dengue in China was 11.28% and the incidence of myocarditis increased with the severity of dengue. The NSD(WS+)/SD patients with myocarditis presented with higher incidence of cardiac complication compared with NSD (WS–) patients with myocarditis. The prognosis of dengue patients with and without myocarditis had no significant difference even if myocarditis patients experienced longer hospital stay.

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Section: Methodsmentioning

confidence: 99%

Characterization of the Myocarditis during the worst outbreak of dengue infection in China

Huang²,

Huang

et al. 2016

Medicine

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“…8 Dengue myocarditis can sometimes masquerade as myocardial infarction. 9,10 However, dengue fever complicated with myocardial infarction is reported in only a few case reports. 11,12,13 The older age, presence of type 2 diabetes and hypertension as risk factors favors preexisting coronary atherosclerosis in these patients.…”

Section: Discussionmentioning

confidence: 99%

Dengue fever complicated with acute ST elevation myocardial infarction - a therapeutic conundrum: our experience from two cases

et al. 2021

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Dengue fever has a wide range of clinical manifestations from asymptomatic disease to complicated dengue haemorrhagic fever and dengue shock syndrome. Bleeding manifestations in dengue is well known but thrombotic events complicating dengue is uncommon. ST elevation myocardial infarction during dengue is rare and poses important management dilemma. At present, there is no consensus on how to manage this situation. We present two patients with dengue fever developing ST elevation myocardial infarction and our experience in the management. We suggest case-based management of acute coronary syndrome in dengue, guided by the degree of thrombocytopaenia and bleeding risk. Further studies are needed to include this into existing dengue management guidelines.

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“…Following a thorough literature search through PubMed and MEDLINE, only a few case reports were found where the clinical presentation had suggested acute myocardial infarction associated with dengue fever [6][7][8][9]. Further evaluation in each of these cases revealed viral myocarditis rather than myocardial infarction to be the actual pathology.…”

Section: Discussionmentioning

confidence: 99%

Coronary Artery Spasms Mimicking Acute ST-Elevation Myocardial Infarction in Dengue Haemorrhagic Fever

Dandeniya

Gawarammana

Weerakoon

2020

Case Reports in Infectious Diseases

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Dengue is an arboviral febrile illness endemic in many tropical and subtropical regions with frequent epidemics. Although most cases are self-limiting, progression into dengue haemorrhagic fever can have dire outcomes. The course can also be complicated by infrequent occurrence of unusual clinical manifestations which are increasingly recognized. We describe the case of a 16-year-old previously healthy girl diagnosed with dengue, who went on to develop severe ischaemic-type central chest pain towards the end of the critical phase of dengue haemorrhagic fever. Urgent investigation revealed acute ST-segment elevations in the high lateral leads of a surface electrocardiogram which completely reverted to normal within 2 hours, associated with elevated cardiac biomarkers but normal findings on transthoracic 2D echocardiography. She was managed with high-dose statins, nitrates, and pain relievers and made an uneventful recovery without any further episodes. The possible explanation for the presentation was focal myocarditis leading to coronary artery spasms.

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Acute myocardial infarction being the presentation of dengue myocarditis

Cited by 13 publications

References 4 publications

Characterization of the Myocarditis during the worst outbreak of dengue infection in China

Characterization of the Myocarditis during the worst outbreak of dengue infection in China

Dengue fever complicated with acute ST elevation myocardial infarction - a therapeutic conundrum: our experience from two cases

Coronary Artery Spasms Mimicking Acute ST-Elevation Myocardial Infarction in Dengue Haemorrhagic Fever

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