# Electrocardiographic Abnormalities in Patients With Leptospirosis: A Clinical Observational Study

## TL;DR

This study finds that ECG abnormalities are common in leptospirosis patients and may indicate disease severity and heart involvement.

## Contribution

The study identifies specific ECG patterns associated with leptospirosis severity and highlights the utility of ECG in early detection.

## Key findings

- ECG abnormalities were observed in most patients, with non-specific ST-T changes and myocarditis-like patterns being most frequent.
- Myocarditis-pattern ECG changes were significantly associated with disease severity.
- Hyponatremia and hypokalemia were common and may contribute to ECG abnormalities.

## Abstract

Background: Leptospirosis is a globally prevalent zoonotic disease with diverse clinical manifestations, including potentially significant cardiovascular involvement. Electrocardiography (ECG) represents a convenient, cost-effective tool for detecting early myocardial and conduction abnormalities in affected patients.

Methods: In this observational study, 108 serologically confirmed leptospirosis patients underwent standard 12-lead ECG recording upon admission. Demographic characteristics, serum sodium, and potassium levels were documented. Patients with pre-existing cardiac disease were excluded. ECG abnormalities were categorized, and their distribution was analyzed using descriptive statistics and correlation tests where appropriate.

Results: The mean age of the cohort was 34 ± 4.76 years with equal sex distribution. Fourteen patients (13%) died, and 43 (40%) required ICU admission. Hyponatremia (mean = 132 mEq/L) and hypokalemia (mean = 3.1 mEq/L) were common. ECG abnormalities were observed in a majority of patients, with non-specific ST-T changes and myocarditis-like patterns being most frequent, followed by left ventricular hypertrophy-like changes with sinus tachycardia, atrial fibrillation, and primary atrioventricular (AV) block. QTc prolongation was uncommon. Myocarditis-pattern ECG changes showed a significant association with disease severity.

Conclusion: ECG abnormalities are common in leptospirosis and may serve as early markers of myocardial involvement and disease severity. Routine ECG evaluation, particularly in severe disease or electrolyte derangement, can assist in timely management. Further studies integrating echocardiography and long-term outcomes are needed to delineate the prognostic value of these findings.