Complete atrioventricular block-an uncommon clinical presentation in an adult patient with proven dengue fever

BMJ Case Rep. 2024 Jan 9;17(1):e257833. doi: 10.1136/bcr-2023-257833.

Abstract

Dengue is a viral disease that clinically presents with fever, thrombocytopenia-related haemorrhagic complications and shock in its severest form. This female patient in her 40s primarily presented to the emergency department of the cardiac centre as syncopal attacks with a complete atrioventricular block. Temporary cardiac pacing as an emergency procedure helped to maintain cardiac rhythm and haemodynamics. A history of recent onset fever helped us to suspect and confirmed by serology for dengue pathology. Normal sinus rhythm was restored after 2 days, and we removed the temporary pacing. Cardiac arrhythmia did not recur in 6 months of follow-up. The aetiology for dengue-related cardiac arrhythmia is still not established. In the recovery phase from fever, complete heart block may show up as a primary presentation in the emergency. Its timely diagnosis and temporary pacing may allow spontaneous recovery. The inclusion of electrocardiography in dengue patient guidelines should help clinicians to dictate its treatment.

Keywords: Arrhythmias; Clinical diagnostic tests; Infections; Pacing and electrophysiology.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Atrioventricular Block* / diagnosis
  • Atrioventricular Block* / etiology
  • Atrioventricular Block* / therapy
  • Cardiac Conduction System Disease
  • Dengue* / complications
  • Dengue* / diagnosis
  • Electrocardiography
  • Female
  • Fever
  • Heart
  • Humans