Cardiac complications of a dengue fever outbreak in Sri Lanka, 2005

A high incidence of cardiac complications was observed in an outbreak of dengue fever at General Hospital, Peradeniya, Sri Lanka, in 2005. This report describes 120 serologically confirmed dengue fever patients who presented during the outbreak. Seventy-five (62.5%) of these patients had electrocard...

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Bibliographic Details
Published in:Transactions of the Royal Society of Tropical Medicine and Hygiene 2007-08, Vol.101 (8), p.804-808
Main Authors: Kularatne, S.A.M., Pathirage, M.M.K., Kumarasiri, P.V.R., Gunasena, S., Mahindawanse, S.I.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Arboviroses
Biological and medical sciences
Bradycardia
Cardiology. Vascular system
Cardiomyopathies - diagnostic imaging
Cardiomyopathies - virology
DEN-3
Dengue - complications
Dengue - epidemiology
Dengue fever
Dengue fevers
Disease Outbreaks
Electrocardiography
Female
Heart
Heart Diseases - epidemiology
Heart Diseases - virology
Human viral diseases
Humans
Infectious diseases
Male
Medical sciences
Middle Aged
Myocarditis
Myocarditis. Cardiomyopathies
Radiography
Sri Lanka
Sri Lanka - epidemiology
Tachycardia
Tropical viral diseases
Viral diseases
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Summary:A high incidence of cardiac complications was observed in an outbreak of dengue fever at General Hospital, Peradeniya, Sri Lanka, in 2005. This report describes 120 serologically confirmed dengue fever patients who presented during the outbreak. Seventy-five (62.5%) of these patients had electrocardiogram changes (T inversion, ST depression, bundle branch blocks) and were assigned to the ‘cardiac group’ (50 females, 25 males; median age 34 years, range 13–76). These patients were more susceptible to fatigue, dyspnoea, low peripheral oxygen saturation in room air ( P = 0.001), chest pain ( P = 0.001) and flushing of skin ( P = 0.05) than 45 (37.5%) patients who had normal electrocardiograms and made up the ‘non-cardiac group’. In the cardiac group there were 31 primary and 44 secondary dengue patients. In the cardiac group, 17 (23%) patients had hypotension and 58 (77%) developed tachycardia and bradycardia ( P < 0.001) compared to four (9%) in the non-cardiac group, suggestive of significant cardiac dysfunction. There was no correlation between pulse rate and body temperature: cardiac group ( r = 0.05; P = 0.63); non-cardiac group ( r = 0.11, P = 0.46). RT-PCR detected DEN-3 in three cardiac patients.
ISSN:0035-9203
1878-3503
DOI:10.1016/j.trstmh.2007.02.021