Echocardiographic findings in infants with presumed congenital Zika syndrome: Retrospective case series study

• Published in: PloS one 2017-04, Vol.12 (4), p.e0175065-e0175065
• Main Authors: Cavalcanti, Danielle Di, Alves, Lucas V, Furtado, Geraldo J, Santos, Cleusa C, Feitosa, Fabiana G, Ribeiro, Maria C, Menge, Paulo, Lira, Izabelle M, Alves, Joao G
• Format: Article
• Language: English
• Subjects: Biology and life sciences; Birth defects; Cardiology; Cardiovascular disease; Cerebrospinal fluid; Computed tomography; Congenital diseases; Continuous radiation; Coronary artery disease; Defects; Doppler effect; Dyspnea; Echocardiography; Electrocardiography; Enzymes; Flavivirus; Heart; Heart diseases; Humans; Immunoglobulin M; Infant; Infants; Infections; Medicine and Health Sciences; Microcephaly; Microencephaly; Newborn babies; Pediatrics; People and Places; Public health; Research and Analysis Methods; Respiration; Retrospective Studies; Rubella; Serology; Sexually transmitted diseases; Syphilis; Systematic review; Toxoplasmosis; Vector-borne diseases; Ventricle; Viral infections; West Nile virus; Zika virus; Zika Virus Infection - congenital; Zika Virus Infection - diagnostic imaging; Zika Virus Infection - physiopathology
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0175065

To report the echocardiographic evaluation of 103 infants with presumed congenital Zika syndrome. An observational retrospective study was performed at Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Brazil. 103 infants with presumed congenital Zika syndrome. All infants had microcephaly and head computed tomography findings compatible with congenital Zika syndrome. Zika IgM antibody was detected in cerebrospinal fluid samples of 23 infants. In 80 infants, the test was not performed because it was not available at that time. All infants had negative serology for HIV, syphilis, rubella, cytomegalovirus and toxoplasmosis. A complete transthoracic two-dimensional, M-mode, continuous wave and pulsed wave Doppler and color Doppler echocardiographic (PHILIPS HD11XE or HD15) examination was performed on all infants. 14/103 (13.5%) echocardiograms were compatible with congenital heart disease: 5 with an ostium secundum atrial septal defect, 8 had a hemodynamically insignificant small apical muscular ventricular septal defect and one infant with dyspnea had a large membranous ventricular septal defect. The echocardiograms considered normal included 45 infants with a persistent foramen ovale and 16 with a minimum patent ductus arteriosus. Preliminarily this study suggests that congenital Zika syndrome may be associated with an increase prevalence of congenital heart disease. However the types of defects noted were septal defects, a proportion of which would not be hemodynamically significant.