To Study the Incidence of Bradycardia and ECG Manifestations in Dengue Infection

BACKGROUND AND OBJECTIVES Dengue is one of the most important mosquito-borne illnesses worldwide [1]. It is a caused by a flavivirus with four distinct serotypes (DENV1, DENV2, DENV3, and DENV4). All the four serotypes of dengue virus are found in our country. Case fatality rates in endemic countries like India are 2.5 %. During epidemics of dengue, attack rates among susceptible are 40-90 %. Early recognition and prompt treatment are vital if disease related morbidity and mortality are to be limited. Clinical features that can be used in the initial assessment of febrile patients are essential tools for clinicians, especially in limited resource settings. Awareness of bradycardia as a clinical finding, could help in the early recognition of dengue and potentially reduce complications and death. The present study was conducted to study the incidence of bradycardia and ECG rhythm changes in Dengue fever. MATERIALS AND METHODS It was a hospital based observational descriptive study.149 eligible dengue fever cases were selected for the study. Appropriate investigations were done. RESULTS A total of 149 patients of Dengue fever were analyzed. The most common age group affected in our study was 20-39 years (53 %). The clinical spectrum of cases included 22 % cases of Dengue fever (DF), 72 % cases of Dengue Hemorrhagic fever (DHF), 5 % cases of Dengue Shock Syndrome (DSS). Clinical pulse rate distribution amongst cases showed 26 % with bradycardia, 64 % with relative bradycardia, and 8 % with tachycardia. Electrocardiographic changes in our study showed 37 % with sinus bradycardia, 48 % with normal sinus rhythm, 1 % with first degree heart block, and 14 % with sinus tachycardia. CONCLUSION Bradycardia was a predominant occurrence amongst total of 149 cases of Dengue fever analyzed.90 % of the cases had bradycardia. (64 % had relative bradycardia and 26 % bradycardia. Majority of the patients on ECG showed sinus bradycardia (37 %) and normal sinus rhythm (48 %). Hence, awareness of bradycardia as a clinical finding, can help in the early recognition of dengue and potentially reduce complications and death associated with dengue virus infection.