Dengue fever continues to be a significant concern in Asia and the Pacific region, with recent reports indicating that the disease is evolving and leading to expanded syndromes with atypical manifestations. One such manifestation is the cardiac involvement seen in patients with dengue fever. A series of cases reported by Indian doctors sheds light on the cardiac complications, specifically myocarditis-induced cardiogenic shock.
Dengue fever is a global health issue, affecting a large portion of the world’s population. In 2022, there was a notable increase in dengue cases worldwide, with India reporting over 2,33,000 cases and 303 deaths. Myocarditis, inflammation of the heart muscle, is a rare but severe complication of dengue. Studies have shown that patients with myocarditis have prolonged hospital stays and elevated levels of cardiac biomarkers, which are associated with increased mortality.
The case series from Lady Hardinge Medical College in New Delhi presented three cases that demonstrate the atypical cardiac manifestations of dengue fever. Each case had different clinical presentations and outcomes, emphasizing the importance of considering myocarditis in dengue patients, even without overt cardiac symptoms.
These observations align with the diagnostic criteria for myocarditis set by the European Society of Cardiology. Additionally, elevated ferritin levels following blood transfusion were found in all cases, suggesting a potential link to inflammation and cardiac dysfunction. Further research is needed to explore these complications and develop improved treatment strategies.
In the absence of specific treatment for the dengue virus, early detection and management of complications are crucial. The rising prevalence of dengue cases and the emerging threat of myocarditis necessitate increased vigilance in clinical settings. Routine cardiac evaluation should be considered for dengue patients, particularly in endemic regions. By recognizing and addressing myocarditis as a complication of dengue fever, healthcare professionals can improve patient outcomes and contribute to the fight against this evolving disease.
In conclusion, the atypical cardiac manifestations of dengue fever, specifically myocarditis-induced cardiogenic shock, underscore the evolving nature of this disease. The medical community must remain vigilant, adapt to the changing landscape of dengue, and work towards better outcomes for affected individuals.