Signing you in

Dr Chirag D, Consultant – Interventional Cardiology, Aster Whitefield Hospitals, Bengaluru, says that although it is not very common, cardiac manifestations of dengue have been well recognised and can range from minor, reversible conditions to life-threatening diseases in severe dengue infection.

Thus, Dr Chirag says it is crucial to take special note of patients with dengue infection who have symptoms such as prolonged chest pain, difficulty breathing, palpitations, lightheadedness, syncope, or hypotension that are unresponsive to adequate fluid replacement.

Quoting studies, Dr Chirag points out that ECG abnormalities such as sinus bradycardia, sinus tachycardia, first-degree atrioventricular block, and non-specific ST-T changes are some of the more commonly seen cardiac findings in dengue patients.

The doctor shares that danger for cardiac complications is considerably greater in people with severe dengue, dengue haemorrhagic fever, or dengue shock syndrome. “This happens because there’s extensive plasma leakage along with widespread inflammation, and that whole circulatory instability really adds a lot to the load on the heart,” Dr Chirag explains, further adding that sometimes myocarditis can move on to acute heart failure, cardiogenic shock, or even serious cardiac arrhythmias, so intensive care management becomes necessary.

Dr Chirag says that not all instances of breathlessness and hypotension observed in patients suffering from dengue fever can be explained by dehydration and plasma leakage alone. It is essential to evaluate cardiac involvement when there is no significant improvement observed with conventional treatment measures.

The good news is that many of the patients with mild involvement of the heart recover well if the disease is diagnosed and treated early.

“Currently, there are no specific anti-viral drugs available for the management of myocarditis due to dengue. However, management of the disease includes keeping the patient hydrated and monitoring the functioning of the heart, along with the management of any other complications arising due to the disease,” Dr Chirag concludes.