Leowattana W, Leowattana T. Dengue hemorrhagic fever and cardiac involvement. World J Meta-Anal 2021; 9(3): 286-296 [DOI: 10.13105/wjma.v9.i3.286]
Corresponding Author of This Article
Wattana Leowattana, BSc, MD, MSc, PhD, Associate Professor, Senior Researcher, Staff Physician, Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajavithi Road, Rachatawee, Bangkok 10400, Thailand. wattana.leo@mahidol.ac.th
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Meta-Anal. Jun 28, 2021; 9(3): 286-296 Published online Jun 28, 2021. doi: 10.13105/wjma.v9.i3.286
Dengue hemorrhagic fever and cardiac involvement
Wattana Leowattana, Tawithep Leowattana
Wattana Leowattana, Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
Tawithep Leowattana, Department of Medicine, Faculty of Medicine, Srinakharinwirot University, Bangkok 10110, Thailand
Author contributions: Leowattana W wrote the paper; Leowattana T collected the data.
Conflict-of-interest statement: The authors declare having no conflicts of interest in relation to this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wattana Leowattana, BSc, MD, MSc, PhD, Associate Professor, Senior Researcher, Staff Physician, Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajavithi Road, Rachatawee, Bangkok 10400, Thailand. wattana.leo@mahidol.ac.th
Received: April 4, 2021 Peer-review started: April 4, 2021 First decision: May 13, 2021 Revised: May 30, 2021 Accepted: July 7, 2021 Article in press: July 7, 2021 Published online: June 28, 2021
Abstract
Dengue viral infection (DVI) is one of the world’s most significant viral infections spreading. Most of the patients have been asymptomatic, with relatively benign clinical manifestations and outcomes. However, a small number of patients have progressed to severe dengue diseases, including hemorrhage, multi-organ impairment, and increased vascular leakage causing hypovolemic shock, which can cause cardiovascular collapse and death. Numerous lines of evidence have demonstrated that DVI could also cause cardiac dysfunction, arrhythmias, and severe myocarditis. The treatment for dengue hemorrhagic fever (DHF) patients remains symptomatic and supportive, with close monitoring of hemodynamic status. The contributory role of cardiac dysfunction in DHF patients has potentially critical implications on the management. This review will address the current knowledge of cardiac involvement in DHF patients and the management strategy to reduce the fatality outcome.
Core Tip: The majority of dengue virus infections (DVIs) are mild; only a small number of the patients develop overt complications and fatal outcomes. Dengue can also have cardiac involvement, including myocardial dysfunction, cardiac rhythm abnormality, and myocarditis which can implicate severe dengue disease and dengue shock syndrome. Fulminant dengue myocarditis has evidence of extensive cardiomyocyte infection and damage, with an abnormality of electrocardiography, echocardiography, and accompanied by elevated cardiac markers. Early recognition of cardiac involvement in DVI patients, intravascular fluid replacement, circulatory overload monitoring, and preparing the essential tools for critical management are crucial in dengue hemorrhagic fever patients with cardiac involvement.
