Dengue Cardiac Infection, A Brief Review

Dear Editors: Dengue is an important mosquito-borne viral disease which is prevalent in many tropical countries. The cardiac complications in dengue are not common. Here, the details of dengue cardiac infection are briefly reviewed. Myocarditis is the most common documented cardiac pathology in dengue, however, only a few cases are reported in the world literature. Wiwanitkit proposed a probable reason for the low incidence of dengue myocarditis, that it might represented the rarity of the cases or it might be due to underdiagnosis and neglecting to report. Wiwanitkit also concluded that such myocarditis was very rare and might not be fatal if early diagnosed and treated. However, in another report from Columbia, there was a high incidence of myocarditis. Concerning the manifestation of dengue myocarditis, Horta Veloso et al, reported that cardiac rhythm disorders, such as atrioventricular blocks and ventricular ectopic beats, can appear during infection and are attributed to viral myocarditis. Dengue endocarditis has never been reported. Indeed, the formed immune complex in dengue infection could not be entrapped in the valvular space, therefore, dengue endocarditis could not exist. Dengue pericarditis can be seen but it is very rare and in the form of myopericarditis. The pathogenesis is believed to be the extension of dengue myocarditis into the pericardium rather than circulating immune complex. At present, dengue pericarditis is extremely rare due to early diagnosis of dengue myocarditis.