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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
Core Tip

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.