Patterns of ECG Manifestations in Dengue Infection
DOI:
https://doi.org/10.3329/jom.v24i2.67274Keywords:
Dengue fever, ECG manifestations, Bradycardia, Transient cardiac symptoms.Abstract
Background: Dengue fever has emerged as one of the most common viral diseases in the world. The clinical manifestation ranges from mild febrile illness to severe disease such as dengue hemorrhagic fever and dengue shock syndrome. Dengue is known to affect various systems. So, different aspects of disease need to be explored. Cardiac involvement in dengue fever is not uncommon and has been reported in literature. ECG is widely used as a screening tool not only because it is easily available but also due to its ability to indicate cardiac involvement.
Objective: The aim of the study was to determine the patterns of ECG changes and their frequency in a cohort of patients with dengue fever (DF) and dengue hemorrhagic fever (DHF) along with the association of ECG changes with severity of dengue infection and clinical manifestation of cardiac involvement.
Method: We conducted a cross-sectional observational study involving 50 patients with dengue fever and dengue hemorrhagic fever, admitted in Medicine department of Dhaka Medical College Hospital, Dhaka from 1st October, 2017 to 31st March, 2018. Admitted patients with high grade fever and positive Dengue IgM, NS1 AG or RT-PCR were included. Patients with electrolyte abnormalities, preexisting heart disease, drugs interfering with heart rhythm were excluded from study. The Standard 12 lead ECG was carried out in study patients on 3rd day of disease onset and on the day of discharge after disease recovery. Frequency & pattern of ECG changes like heart rate, rhythm, P wave, T wave, ST segments and QRS complex were analyzed and recorded. Statistical analysis was done using SPSS 25 on windows 10. Categorical and numerical data’s were expressed as frequencies and percentage. Cross tabulation was done between DF and DHF with different ECG findings. To establish the significance of various findings and association in between variables chi-square analysis, Pearson correlations were done in all cases. P value < 0.05 considered significant
Result: Total 50 patients with dengue fever were enrolled, 39 patients (78%) were diagnosed as dengue fever and 11 patients (22%) were diagnosed as dengue hemorrhagic fever (DHF). Mean age of the patient was 33.08 ± 9.79 years. Male – female ratio of 1.5:1 fever was noted in all 50 patients (100%), myalgia (94%), headache (84%), skin rash (82%), & retro-orbital pain(54%), vomiting (26%), only 3 patients (6%) complained about abdominal pain. Only 4 patients had cardiac symptoms. 3 patients complained about palpitation and only 1 patient had symptom of chest pain and dyspnea. In most of the patients, (34 in number, 68%) ECG was normal. Only 16 patients (32%) had abnormal findings in ECG. 9 patients (18%) had bradycardia, 3 patients (6%) had tachycardia, 2 Patient (4%) had T Inversion and 1 patient (2%) had ST elevation and 1 patient (2%) had ST depression. Among total 16 abnormal ECG, predominant finding was bradycardia (>50% of abnormal ECG). P value is <0.01. Correlation of ECGs with clinical severity (Dengue fever and Dengue Hemorrhagic fever) found no statistically significant association (P value is 0.725).
J MEDICINE 2023; 24(2): 119-124
Downloads
4
20
Downloads
Published
How to Cite
Issue
Section
License
![Creative Commons License](http://i.creativecommons.org/l/by-nc-nd/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).