Dengue and the Heart: A Retrospective Study of Electrocardiographic Changes

TL;DR

This study found that heart-related ECG changes, especially slow heart rate, are common in dengue patients and may not be linked to other severe symptoms.

Contribution

The study highlights the importance of routine ECG monitoring in dengue to detect cardiac involvement early.

Findings

ECG abnormalities were found in 23.9% of dengue patients.

Sinus bradycardia was the most common ECG change, observed in 13.3% of patients.

Most patients with ECG changes were aged 18-35 and had no significant comorbidities.

Abstract

Introduction: Dengue fever, an arboviral infection, has been associated with various systemic complications, including cardiac involvement. Electrocardiographic (ECG) abnormalities in dengue are underreported but may indicate transient or serious myocardial dysfunction. This study aims to assess the prevalence and nature of ECG changes, especially sinus bradycardia, in patients with dengue fever and to examine their correlation with clinical and laboratory parameters.

Methods: A retrospective cross-sectional study was conducted at the Department of General Medicine, Indira Gandhi Medical College and Research Institute, Pondicherry, including 301 dengue-positive patients admitted between January 1, 2023, and December 31, 2023. Data were collected from medical records, including demographics, clinical features, comorbidities, laboratory values, and ECG findings.

Results: ECG abnormalities were found in 72 patients (23.9%). The most frequent finding was sinus bradycardia, observed in 40 patients (13.3%), followed by sinus tachycardia in 18 patients (6%) and ST-T wave changes in six patients (2%). Rare conduction abnormalities were also noted. No significant differences were observed in hematological, renal, or hepatic parameters between patients with and without bradycardia. Most patients with ECG changes were between 18 and 35 years of age. Gender distribution was nearly equal, and most had no significant comorbidities.

Conclusion: Sinus bradycardia is a notable ECG abnormality in dengue fever and may occur independently of laboratory or clinical severity markers. Routine ECG monitoring should be incorporated into dengue management protocols to identify cardiac involvement early and avoid complications.

Figures