SIGNIFICANCE OF VENTRICULAR REPOLARIZATION ABNORMALITIES IN DENGUE VIRAL FEVER

Narveer Singh, D. K Sharma, Yatin Gupta

Abstract


                    Infection by Dengue virus (DENV) is an arboviral disease affecting large no of population every year especially in underdeveloped and developing countries. In India every year, lacks of people suffer from it and mortality is well known in both DHS &DSStype of manifestations. Vector responsible is a mosquito, Aedes aegypti and/or Aedes albopictus. It breeds in fresh water bodies. Disease presents as fever with accompanying symptoms like, body ache, headache, nausea, vomiting, hemorrhagic spots or bleedings from various sites. Most common laboratory findings are leucopenia and thrombocytopenia. ECG changes do occur in this disease in relation to myocardial edema, however little importance has been given regarding ventricular repolarization so far. This study has been aimed to evaluate the QTc and QT interval dispersion to recognize ventricular repolarization changes in patients suffering from Dengue viral fever and to assess the grade of severity in relation to prognosis and referring a case to higher center for necessary evaluation and management of dengue fever and its complications.

Fifty consecutive patients were included in study during dengue epidemic period. ECG of fifty age and sex matched normal individuals recorded as control group. Routine laboratory tests were performed along with 12 lead ECG. Interval values of QT, QT and QT dispersion were specially calculated with care in addition to other variables. QTc and QT intervals of both groups were compared for statistical significance and values of case group were found significantly higher (p-value <0.05), for QTc values. No significant difference detected in QT values while QT dispersion found to have week correlation in this study.

           This was concluded that ventricular repolarization do suffer in dengue fever, as disease is affecting multiple organs including heart causing temporary myocardial injury and edema. It is worthwhile to record 12 lead ECG in all cases of dengue fever which is otherwise not a routine investigation unless patients develop complications.


Keywords


DHS, dengue hemorrhagic syndrome, DSS, dengue shock syndrome, QTc, QT corrected for heart rate

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