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等待与信任:登革热感染所致缓慢性心律失常的保守治疗:一例报告

Wait and trust: conservative management of bradyarrhythmias due to dengue infection: a case report.

作者信息

Cortez Maicol, López Bryam, Angulo Bryan, Palomino Milagros, Mancha Carlos

机构信息

Department of Cardiology, Edgardo Rebagliati Martins National Hospital, Avenida Edgardo Rebagliati 490, Jesús María, Lima 15072, Perú.

出版信息

Eur Heart J Case Rep. 2024 Dec 26;9(1):ytae696. doi: 10.1093/ehjcr/ytae696. eCollection 2025 Jan.

Abstract

BACKGROUND

This case report highlights the conduction disorder anomalies associated with dengue infection, particularly bradyarrhythmias due to dysfunction of the sinus node and atrioventricular node, which may require cardiac stimulation such as pacemaker implantation. This case emphasizes the importance of continuous monitoring and the use of additional diagnostic techniques to detect complications in a timely manner.

CASE SUMMARY

A 31-year-old male patient was admitted to our institution with symptoms of dyspnoea, orthopnoea, and severe bradycardia. During hospital admission, atrial fibrillation with a low ventricular response was evident. A 24-h Holter examination revealed additional electrical conduction abnormalities, including first-, second-, and third-degree atrioventricular block, 3.8 s pauses, and migrating atrial rhythm. Since the patient remained asymptomatic and did not present circulatory compromise, conservative management was chosen, with gradual recovery observed during the 30-day follow-up.

DISCUSSION

Dengue can significantly affect the cardiovascular system, presenting a variety of abnormalities in cardiac conduction. This case highlights electrical abnormalities and the importance of proper evaluation and management. It was decided to avoid temporary or permanent pacemaker implantation. This case underscores the need for continuous monitoring and the use of alternative diagnostic tools demonstrating that arrhythmias in this context can be successfully managed conservatively.

摘要

背景

本病例报告强调了与登革热感染相关的传导障碍异常,特别是由于窦房结和房室结功能障碍导致的缓慢性心律失常,这可能需要心脏刺激,如植入起搏器。本病例强调了持续监测以及使用额外诊断技术及时发现并发症的重要性。

病例摘要

一名31岁男性患者因呼吸困难、端坐呼吸和严重心动过缓入住我院。住院期间,明显存在心室率缓慢的心房颤动。24小时动态心电图检查显示额外的电传导异常,包括一度、二度和三度房室传导阻滞、3.8秒的停搏以及游走性房性心律。由于患者仍无症状且未出现循环功能障碍,因此选择了保守治疗,在30天的随访期间观察到病情逐渐恢复。

讨论

登革热可显著影响心血管系统,导致心脏传导出现多种异常。本病例突出了电异常以及正确评估和管理的重要性。决定避免植入临时或永久性起搏器。本病例强调了持续监测和使用替代诊断工具的必要性,表明在这种情况下心律失常可以成功地进行保守治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bfa2/11718385/45c1ca9aa715/ytae696il2.jpg

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