Abstract
ABSTRACT Introduction: Dengue infection rarely affects the heart, but clinical symptoms of cardiac involvement may range greatly from a silent illness to severe myocarditis resulting in death. With the increasing incidence of dengue fever, reports of atypical manifestations are on the rise, these may be underreported because of a lack of awareness and underdiagnosed Cases: A 40-year-old man presents with acute fever for three days with positive non-structural protein 1 (NS1) and asymptomatic bradycardia. ECG revealed sinus rhythm (40 bpm) with an absence of ST-segment elevation. His laboratory examination showed a rise in NT-Pro BNP and CKMB levels. Echocardiography showed hyperechogenic myocardium suspicious for myocarditis, with a left ventricle ejection fraction (LVEF) of 73% and no systolic, diastolic, or valve abnormalities. The patient recovered without further complications and was discharged home. Conclusion: Cardiac involvement is uncommon and encountered in centres which handle large numbers of patients with dengue infection. Clinical manifestations of cardiac involvement in dengue infection can vary widely, from an incidental finding to severe cardiac failure resulting in death. Keywords: bradycardia; dengue infection; myocarditis; NS1
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