Cardiac involvement in dengue infection

  • Mitrakrishnan C Shivanthan National Hospital of Sri Lanka, Regent Street, Colombo, Sri Lanka
  • Mitrakrishnan R Navinan National Hospital of Sri Lanka, Regent Street, Colombo, Sri Lanka
  • Godwin Roger Constantine Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
  • Senaka Rajapakse Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
Keywords: dengue, myocarditis, pericarditis, shock, heart, cardiac, calcium

Abstract

Introduction: Dengue is endemic in the tropics, and complications involving organ systems are seen with varying incidence.

Methodology: We performed a systematic review. MEDLINE, EMBASE, Scopus SciVerse, Google Scholar, and LILACS were searched for papers providing information on cardiac involvement in dengue.

Results: Cardiac involvement is not uncommon in dengue infection and is often transient, but may be associated with significant morbidity and even mortality. Direct viral invasion, immune mechanisms, electrolyte imbalance, derangement of intracellular calcium ion storage, lactic acidosis, and ischemia due to hypotension all play a role in myocardial dysfunction. The manifestations of cardiac involvement include clinical, electrocardiographic, echocardiographic, cardiac enzyme, and histopathologic abnormalities. Echocardiography appears to be a useful tool for detecting myocardial involvement and should be performed in patients with electrocardiographic abnormalities or hemodynamic instability. Treatment is largely supportive, though there are some anecdotal reports of improvements with specific agents.

Conclusions: Knowledge on cardiac manifestations in dengue is limited, and further studies are needed to establish the exact pathophysiology and role of specific agents in the prevention and treatment of cardiac complications in dengue.

Author Biographies

Mitrakrishnan C Shivanthan, National Hospital of Sri Lanka, Regent Street, Colombo, Sri Lanka

Consultant Physician, National Hospital of Sri Lanka, Regent Street, Colombo 7, Sri Lanka

Mitrakrishnan R Navinan, National Hospital of Sri Lanka, Regent Street, Colombo, Sri Lanka
Registrar in Medicine, National Hospital of Sri Lanka, Regent Street, Colombo 7, Sri Lanka
Godwin Roger Constantine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka

Senior Lecturer & Consultant Cardiologist, Department of Clinical Medicine, Faculty of Medicine, University of Colombo, 25, Kynsey Road, Colombo 08,  Sri Lanka

 

Senaka Rajapakse, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka

Professor & Consultant Physician, Department of Clinical Medicine, Faculty of Medicine, University of Colombo, 25, Kynsey Road, Colombo 08,  Sri Lanka

Published
2015-04-15
How to Cite
1.
Shivanthan MC, Navinan MR, Constantine GR, Rajapakse S (2015) Cardiac involvement in dengue infection. J Infect Dev Ctries 9:338-346. doi: 10.3855/jidc.6200
Section
Emerging Problems in Infectious Diseases