Korean Circ J.  2016 Nov;46(6):866-869. 10.4070/kcj.2016.46.6.866.

Complete Heart Block in Association with Dengue Hemorrhagic Fever

• Virk HU
• Inayat F
• Rahman ZU

• KMID: 2355465
• DOI: http://doi.org/10.4070/kcj.2016.46.6.866

Abstract

Dengue virus infection affects the heart structurally and functionally. Clinical manifestations of cardiac complications secondary to dengue virus infection vary from self-limiting arrhythmias to severe myocardial infarction, leading to hypotension, pulmonary edema, and cardiogenic shock. However, we report a case of dengue hemorrhagic fever (DHF) complicated by a complete heart block. A female with DHF due to dengue virus serotype 2, presented to the emergency department with fever, headache, rash, and fatigue followed by an episode of syncope. She was found to have a third-degree atrioventricular block, with pulseless polymorphic ventricular tachycardia. Patient was resuscitated and a temporary trans-venous pacemaker was placed. She reverted back to normal sinus rhythm after 4 days of syncope and was subsequently discharged from the hospital after complete resolution of symptoms, without the need for a permanent pacemaker. Physicians are warranted to have high index of suspicion for dengue virus infection as an etiology in patients with acute cardiovascular compromise, especially in tropical areas.

Keyword

Dengue hemorrhagic fever; Heart block

MeSH Terms

Arrhythmias, Cardiac
Atrioventricular Block
Dengue Virus
Dengue*
Emergency Service, Hospital
Exanthema
Fatigue
Female
Fever
Headache
Heart Block*
Heart*
Humans
Hypotension
Myocardial Infarction
Pulmonary Edema
Serogroup
Severe Dengue*
Shock, Cardiogenic
Syncope
Tachycardia, Ventricular

Figure

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  Fig. 1 Baseline normal sinus rhythm.

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  Fig. 2 Complete/third-degree heart block following syncopal attack.

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  Fig. 3 Polymorphic ventricular tachycardia (V-tach) without pulse.

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  Fig. 4 After achieving return of spontaneous circulation and placing temporary trans-venous pacemaker.

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