Asymptomatic Cardiac Rhythm Abnormality in Children with Dengue Virus Infection

Ni Putu Veny Kartika Yantie; Eka Gunawijaya; I Wayan Suradipa; I Wayan Gustawan

doi:10.15562/bmj.v5i2.209

Asymptomatic Cardiac Rhythm Abnormality in Children with Dengue Virus Infection

Ni Putu Veny Kartika Yantie ,

Eka Gunawijaya ,

I Wayan Suradipa ,

I Wayan Gustawan ,

PDF |
DOI: https://doi.org/10.15562/bmj.v5i2.209 |
Published: 2016-07-28

Abstract

Background: In 2012, the reported number of dengue fever cases in Indonesia were 90.245, with a mortality rate reached 0.88%. Cardiac complications are uncommon in dengue virus infection, but it can be occurring. Myocarditis is the most common cardiac complication reported worldwide. Case: We report 10 cases of dengue virus infections with ECG abnormalities in normal heart structure. Based on ECG test during the covalescent stage, sinus arrhythmias were present in 3 patients, sinus bradycardia in 3 patients, sinus tachycardia without fever in 1 patient, first-degree AV block in 2 patients and mobitz type I second-degree AV block in 1 patient. The ECG abnormalities which were found in all cases did not cause any clinical symptoms, then no medication were needed. Continues clinical monitoring was done in all of our cases, and ECG evaluation showed improvement after several days. Conclusions: Myocarditis following dengue infection was clinically diagnosed in some asymptomatic children and need a ECG evaluation. Continues monitoring needed in patient who develop cardiac rhythm abnormalities and all the patient completely recovery.

References

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[1] Hadinegoro SR, Moedjito I, Chairulfatah A. Pedoman diagnosis dan tatalaksana infeksi virus dengue pada anak. 1st Ed. Jakarta: BP IDAI; 2014.

[2] Kularatne SAM, Pathirage MMK, Kumarasiri PVR, Gunasena S, Mahindawanse SI. Cardiac complications of dengue fever outbreakin Sri Langka 2005. Trans R Soc Trop Med Hyg. 2007;101:804-8. doi: 10.1016/j.trstmh.2007.02.021

[3] Kumar AS, Sibia RS. Atypical presentations in dengue viral infection : experiences at a tertiary care centre in north India. Academic Medical Journal of India. 2014;2:92-4.

[4] La-Orkhun V, Supachokchaiwattana P, Lertsapcharoen P, Khongphatthanayothin A. Spectrum of cardiac rhythm abnormalities and heart rate variability during the convalescent stage of dengue virus infection: a holter study. Ann Trop Paediatr. 2011;31:123-8. doi: 10.1179/1465328111Y.0000000008

[5] Yacoub S, Wertheim H, Simmons CP, Screaton G, Wills B. Cardiovascular manifestations of the emerging dengue pandemic. Nat Rev. 2014;11:335-45. doi: 10.1038/nrcardio.2014.40

[6] Shivanthan MC, Navinan MR, Constantine GR, Rajapakse S. Cardiac involvement in dengue infection. J Infect Dev Ctries. 2015;9:338-46. doi: 10.3855/jidc.6200.

[7] Kaushik JS, Gupta P, Rajpal S, Bhatt S. Spontaneous resolution of sinoatrial exit block and atrioventricular dissociation in a child with dengue fever. Singapore Med J. 2010;51:146-9. PMID: 20938598

[8] Sharma JK, Zaheer S. Variable atrio-ventricular blok in dengue fever. Academic Medical Journal of India. 2014;15:252-4.

[9] Khongphatthallayothin A, Chotivitayatarakorn P, Somchit S, Mitprasart A, Sakolsattayadorn S, Thisyakorn C. Morbitz type I second degree av block during recovery from dengue hemorrhagic fever. Southeast Asian J Trop Med Public Health. 2000;4:642-5. doi: 10.1038/nrcardio.2014.40.

[10] Promphan W, Sopontammarak S, Pruekprasert P, Kajornwattanakul W, Kongpattanayothin A. Dengue myocarditis. Southeast Asian J Trop Med Public Health. 2004;35:611-3.

[11] Salgado DM, Eltit JM, Mansfield K, Panqueba C, Castro D, Vega MR, et al. Heart and skeletal muscle are targets of dengue virus infection. Pediatr Infect Dis J. 2010;29:238-42. doi: 10.1097/INF.0b013e3181bc3c5b.

[12] Madiyono B. Distrimia. Dalam : Sastroasmoro S, Madiyono B, penyunting. Buku Ajar Kardiologi Anak. Jakarta: BP IDAI; 1994. p. 443-72

Asymptomatic Cardiac Rhythm Abnormality in Children with Dengue Virus Infection

Abstract

References

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