Parchani Ashwin, Krishnan Vs Gokul, Kumar V K Sunil
Department of Internal Medicine, All India Institute of Medical Sciences, Rishikesh, 249203, India.
Department of Internal Medicine, Kasturba Medical College, Manipal, 576104, India.
Int J Gen Med. 2021 Sep 14;14:5607-5614. doi: 10.2147/IJGM.S328755. eCollection 2021.
Dengue fever is a prevalent viral disease that primarily affects tropical nations. Although most symptomatic infections have a relatively benign course, a small percentage of patients experience severe clinical symptoms, such as bleeding and endothelial dysfunction, which can lead to hypovolemic shock and cardiovascular collapse. Dengue fever is now known to involve the heart by inducing myocardial inflammation, arrhythmias, and, in rare cases, fulminant myocarditis, up to 13% in severe dengue. Conduction abnormalities can range from benign sinus bradycardia to fulminant tachyarrhythmias and atrioventricular blocks. Although most conduction disturbances are benign and transient, they can occasionally aggravate pre-existing conditions and even be fatal. Unlike other viral myocarditis like hepatitis C induced myocarditis, dengue causes mainly transient changes, and long-term complications like dilated cardiomyopathy are not noted. There is indeed a paucity of data on how to assess and treat individuals with conduction abnormalities. In this review, the authors have discussed the wide variety of conduction abnormalities seen in dengue, their pathophysiology, clinical consequences, and a method for evaluating and managing these individuals.
登革热是一种主要影响热带国家的常见病毒性疾病。虽然大多数有症状的感染病程相对良性，但一小部分患者会出现严重的临床症状，如出血和内皮功能障碍，这可能导致低血容量性休克和心血管衰竭。现在已知登革热会通过引发心肌炎症、心律失常，以及在罕见情况下引发暴发性心肌炎（严重登革热患者中高达13%）累及心脏。传导异常范围可从良性窦性心动过缓到暴发性快速心律失常和房室传导阻滞。虽然大多数传导障碍是良性且短暂的，但它们偶尔会加重原有病情，甚至可能致命。与其他病毒性心肌炎如丙型肝炎诱导的心肌炎不同，登革热主要引起短暂变化，未发现扩张型心肌病等长期并发症。关于如何评估和治疗有传导异常的个体，确实缺乏数据。在这篇综述中，作者讨论了登革热中出现的各种传导异常、其病理生理学、临床后果，以及评估和管理这些个体的方法。
