Jemds.com Original Research Article J. Evolution Med. Dent. Sci./eISSN- 2278-4802, pISSN- 2278-4748/ Vol. 6/ Issue 07/ Jan. 23, 2017 Page 570 MAGNITUDE OF CARDIAC INVOLVEMENT IN DENGUE FEVER Banwari Lal Yadav 1 , Leeneshwar Harshvardhan 2 , Kuldeep Singh Yadav 3 1 Medical Officer, SDH, Kotputli. 2 Professor, Department of Medicine, SMS Medical College and Attached Hospital, Jaipur. 3 Senior Resident, Department of Psychiatry, SMS Medical College and Attached Hospital, Jaipur. ABSTRACT BACKGROUND The present study was conducted to find out the proportion of dengue fever cases with cardiac involvement. MATERIALS AND METHODS It was a hospital based observational descriptive study. 104 eligible dengue fever cases were selected for the study. Appropriate investigations were done. RESULTS It was found that a significant number of patients of dengue developed asymptomatic involvement of heart as evidenced by electrocardiography changes, raised cardiac enzymes. CONCLUSION Myocardial involvement in most of the cases was found to be subclinical on 2-D echo. KEYWORDS Dengue, Myocardial Involvement. HOW TO CITE THIS ARTICLE: Yadav BL, Harshvardhan L, Yadav KS. Magnitude of cardiac involvement in dengue fever. J. Evolution Med. Dent. Sci. 2017;6(7):570-574, DOI: 10.14260/Jemds/2017/122 BACKGROUND Dengue fever (DF), the most prevalent arthropod-borne viral illness in humans, is caused by the dengue virus (DENV). The 4 serotypes of DENV (DENV 1-4) are transmitted to humans primarily by the Aedes aegypti mosquito. [1] Dengue is the most rapidly spreading mosquito-borne viral disease in the world. In the last 50 years, incidence has increased 30-fold with increasing geographic expansion to new countries and in the present decade from urban to rural settings. An estimated 50 million dengue infections occur annually and approximately 2.5 billion people live in dengue endemic countries. [2] Severe dengue infections may give rise to many complications such as liver failure, disseminated intravascular coagulation, encephalopathy, myocarditis, acute renal failure, and haemolytic uremic syndrome. [3] Although these complications are generally rare, in recent years they have been reported with increasing frequency. Although shock in DHF/DSS has been attributed largely to decreased intravascular volume due to capillary leakage of plasma into the interstitial space, a few recent studies have reported that it may be due to cardiac involvement. [4,5,6,7] Some authors reported direct cardiac involvement in dengue fever patients (Obeyesekere [8] and Hermon, 1973; Wali et al 1998 [5] ; Promphan et al 2004 [9] ). Their study investigated the extent of myocardial involvement in dengue Financial or Other, Competing Interest: None. Submission 10-12-2016, Peer Review 10-01-2017, Acceptance 16-01-2017, Published 23-01-2017. Corresponding Author: Dr. Banwari Lal Yadav, C/o. Doormal Yadav, B-3, Sharma Colony, Kartarpura Phatak, Jaipur-302015. E-mail: drbanwari2003@gmail.com DOI: 10.14260/jemds/2017/122 fever patients, compared with other groups with infectious diseases. (Ehrhardt et al, 2004, 2005). [10] The purpose of this study was to assess whether there is any form of cardiac involvement (Clinical or subclinical) in dengue and DHF, because most of our dengue patients had raised cardiac markers. Aims & Objectives To find out the proportion of Dengue Fever cases with cardiac involvement. MATERIALS & METHODS This study was conducted in the Department of General Medicine, S.M.S. Medical College & Attached Group of Hospitals, Jaipur. It was a hospital based observational descriptive study and was carried out from April 2014 to August 2015. 104 eligible dengue fever cases were included on first come first basis after beginning of the study. The local research ethics committee approved the study. All patients gave written informed consent to participate; for those patients in critical condition or aged <18 years, an informed consent was obtained from their relatives or legal guardians. Both primary dengue (NS-1 antigen or IgM or both positive) and secondary (NS-1 antigen or IgM and IgG antibody positive) dengue cases were included. Patients who had any known cardiac disease, chronic kidney disease, diabetes mellitus, hypertension were excluded. Blood samples of probable dengue patients were tested for NS1 antigen using ELISA technique from the kit supplied by Pan Bio-company. Dengue IgM antibody MAC ELISA kit supplied by SD Company. IgG ELISA by rapid test kit supplied by SD company. The following parameters were considered and/or measured in all patients: Age, gender, blood pressure, routine