4.1 Article

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

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OXFORD UNIV PRESS
DOI: 10.1016/j.trstmh.2007.02.021

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dengue fever; DEN-3; myocarditis; bradycardia; tachycardia; Sri Lanka

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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 blacks) and were assigned to the 'cardiac group' (50 females, 25 mates; median age 34 years, range 13-76). These patients were more susceptible to fatigue, dyspnoea, tow 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. (c) 2007 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

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