Cardiac Manifestations of Acute Febrile Illness Amongst Intensive Care Unit Patients

Abstract

Background: There are various incidences of cardiac involvement in acute febrile illness (AFI). As the acute febrile illnesses are spreading, there is an increase in atypical cardiac manifestations ranging from asymptomatic bradycardia to life threatening manifestations like myocarditis and pericardial effusion. Objective: To determine cardiac manifestations of AFI amongst intensive care unit patients in rural populations. Methods: Twenty patients of AFI were studied between January 2021 to June 2021. Echocardiography (ECG), and cardiac enzymes were evaluated. Patients were from either gender from 15 to 60 years and were willing to sign consent. patients admitted with fever and on examination were found abnormal cardiac functions like hypotension, arrhythmia, hypertension, cardiac enzyme changes and reduced ejection fraction on 2D Echo. Patients with preexisting heart disease, cardioactive drugs affecting the heart rate were not involved in this study. Results: In total, 20 patients having cardiac manifestations with AFI were studied, out of which 9 cases presented with bradycardia, 3 cases presented with asymptomatic pericardial effusion, and 8 cases presented with ECG abnormalities such as narrow QRS complex, ST, and T changes. Conclusion: Cardiac Manifestations in adults with AFI were common, ranging from elevated cardiac biomarkers to myocarditis. Persistent shock despite adequate fluid resuscitation can be a crucial cardiac manifestation and should guide the treating physician towards underlying cardiac involvement such as systolic or diastolic dysfunction.