Spontaneous coronary hematoma concomitant with myocarditis: the first report of double cardiac complication of dengue

We reported the case of a 33‐year‐old male who presented a dengue infection complicated by spontaneous coronary artery intramural hematoma associated with acute myocarditis. The initial presentation was a typical acute coronary syndrome with ST‐segment elevation. Coronary angiography and endocoronary optical coherence tomography confirmed the diagnosis of left anterior descending artery intramural hematoma. Cardiac magnetic resonance imaging revealed not only typical ischaemic injury but also lesions of acute myocarditis confirmed by native T1‐ and T2‐mapping, sub‐epicardial late gadolinium enhancement and pericardial effusion. This case highlights the multiple cardiac damages caused by dengue virus, their possible association (coincidental or linked?), and the impact of multimodal imaging on diagnosis and management.

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Spontaneous coronary hematoma concomitant with myocarditis: the first report of double cardiac complication of dengue

Corré

Vally

Boiron

et al. 2022

ESC Heart Failure

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Relationship Between Myocarditis and Dengue

Melo Lopes,

Dantas Fernandes Veras,

Zenette Alves Guedes Da Silva

et al. 2024

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Introduction: Myocarditis, an inflammation of the heart muscle, can arise as a complication of dengue fever, a mosquito-borne disease. It is essential to adopt a multidisciplinary approach to monitor and treat cardiac complications in patients with dengue fever at an early stage. Diagnostic tests include serology, PCR, and echocardiography. From a review study on cardiac involvement in dengue, it was found that this complication is significant and demands a multidisciplinary approach . Objective: The objective of this study was to conduct a comprehensive integrative review to explore the relationship between myocarditis and dengue fever. Methodology: Articles were searched in databases such as PubMed, Google Scholar,Ministry of Health, and ScienceDirect, using search terms in both Portuguese and English. Out of 122 articles found, 74 were selected for analysis, and 13 were included in the results. Results: The studies examined the relationship between dengue fever and myocarditis, with a focus on the cardiovascular manifestations of dengue fever and the prevalence of myocarditis in infected patients. Analysis of the articles revealed a significant prevalence of myocarditis in patients with dengue, highlighting a strong association between the two conditions. Discussion: Dengue patients frequently present with cardiac issues such as myocarditis, necessitating early detection to prevent serious complications. Effective vector control is crucial to reducing the impact of dengue. These findings provide direction for future research and the development of targeted therapies. Conclusion: Early identification of cardiac complications, such as myocarditis in dengue patients, is crucial to reducing morbidity and mortality. Ongoing research into the pathophysiological mechanisms is vital for the development of specific treatments. The study concludes that myocarditis is commonly associated with dengue, requiring meticulous medical monitoring.

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Dengue e sua correlação com as comorbidades cardíacas: uma revisão integrativa

Santos,

Alves,

Queiroz

et al. 2024

Cuad. Ed. Desar.

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INTRODUÇÃO: A dengue, arbovirose cujo vírus é transmitido principalmente pelo mosquito Aedes aegypti, é uma doença que representa uma ameaça significativa à saúde mundial devido à alta incidência, principalmente nos países em desenvolvimento. Embora a maioria das infecções por este vírus apresente sintomas leves, alguns casos podem evoluir para manifestações mais graves como a Síndrome Expandida da Dengue, que afeta principalmente o sistema cardiovascular. MÉTODOS: Para a realização deste estudo foi realizada uma revisão bibliográfica integrativa utilizando dados do PubMed e Scielo, por meio da combinação das palavras chaves “dengue”, “síndrome expandida da dengue”, “coração” com o operador AND. Adicionalmente, foram incluídos artigos escritos em inglês e publicados a partir de 2016. Isso levou à descoberta de 303 estudos, que passaram por critérios de inclusão e exclusão, restando apenas 22 artigos incluídos nesta revisão. RESULTADOS: O comportamento do coração durante uma infecção por DENV (Vírus Dengue) é variável, podendo ocorrer desde alterações na frequência cardíaca até em inflamação do músculo cardíaco e bloqueio da condução elétrica, que pode ser letal para tais músculos. A infecção por dengue afeta as células do coração, provocando inflamação e disfunção da bomba cardíaca. A gravidade está ligada ao extravasamento plasmático e às citocinas. Miocardite, arritmias e elevação de troponina são frequentes, destacando a importância do diagnóstico e acompanhamento cardíaco pós-infecção por dengue. Além disso, insuficiência cardíaca e bloqueio cardíaco também foram observados. CONCLUSÃO: A extensão dos problemas cardíacos após a infecção por dengue exige que a comunidade médica esteja ciente dessas mudanças, a fim de fornecer aos pacientes tratamentos mais coerentes.

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Spontaneous coronary hematoma concomitant with myocarditis: the first report of double cardiac complication of dengue

Cited by 3 publications

References 11 publications