Abstract
Dengue fever is an important public health problem with diverse manifestation. One of the complication is myocarditis. In current study, we assessed the clinical, electrocardiographic and echocardiographic features of Dengue fever related myocarditis and compared it with similar published studies. All adult patients with Dengue fever transferred to medical ICU of Ittefaq Hospital during the epidemic of dengue fever from July 2011 to October 2011 were included. Patient admitted in ICU with hypotension were classified in to four sub groups: Hypovolemic shock, cardiogenic shock, Dengue hemorrhagic shock and Dengue leakage shock. Patients with cardiogenic shock were analyzed for demographic details, clinical and laboratory features. A total of 24 patients were identified as having Myocarditis. 20 (83.3%) were male and 3(12.5%) were female. Mean age of the patients was 32 years. Most common clinical features were shortness of breath (100%), fatigue (100%), palpitations (100%) and hypotension(100%). Electrocardiography revealed Sinus tachycardia in 21(87.5%), Atrial fibrillation in2(8.3%), Ventricular tachycardia in 1(4.1). Echocardiogram revealed global hypokinesia, low ejection fraction and biventricular enlargement in all patients(100%). Cardiac biomarker like Troponin T and Creatinine Kinase were elevated in all 24(100%) patients. 20(83.3%) patients expired and 4(16.6%) improved completely and discharged. So we can conclude that dengue fever associated myocarditis is poorly reported but an important complication associated with high mortality in our patient. Clinical, electrocardiographic and echocardiographic findings are nonspecific and high degree of the clinical awareness is required from the physician for the timely diagnosis.