ECG Alterations in Adult Vietnamese with Mild Dengue Infection

Overview

This study characterized electrocardiogram (ECG) abnormalities in adult Vietnamese patients with non-severe dengue infection. ECG changes were common but mostly nonspecific and transient, with sinus bradycardia and QTc prolongation among the frequent findings. The clinical significance of these ECG alterations in mild dengue remains uncertain.

Background

Dengue is a mosquito-borne viral infection that can range from mild febrile illness to severe disease involving plasma leakage, shock, hemorrhage, or organ dysfunction including myocarditis. Cardiac manifestations in dengue vary widely, with ECG abnormalities reported in up to 60% of hospitalized patients. The pathophysiology includes endothelial activation, electrolyte imbalance, and immune-mediated myocarditis. While ECG changes are well described in severe dengue, data on ECG abnormalities in non-severe dengue, particularly in Vietnam, are limited.

Data Highlights

Key Findings

• ECG abnormalities were common in adult Vietnamese patients with non-severe dengue infection.
• Sinus bradycardia was frequently observed among ECG changes.
• QTc prolongation was noted, with the Fridericia correction formula used for accuracy.
• ST segment and T wave changes were rare and typically associated with severe dengue.
• Most ECG abnormalities were transient and resolved over time.
• There was no strong correlation between ECG abnormalities and clinical severity in mild dengue cases.

Clinical Implications

Routine ECG monitoring in patients with non-severe dengue may detect transient cardiac conduction abnormalities such as sinus bradycardia and QTc prolongation. However, given the nonspecific nature and resolution of these changes, ECGs should be reserved for patients with clinical signs suggestive of cardiac involvement or severe disease. Awareness of potential ECG alterations can aid clinicians in monitoring and managing dengue patients, especially in resource-limited settings.

Conclusion

ECG abnormalities occur frequently but are mostly nonspecific and transient in adult Vietnamese patients with mild dengue infection. Their clinical significance remains unclear, underscoring the need for further research to define the role of ECG in dengue management.

References

1. WHO 2009 -- Dengue Guidelines for Diagnosis, Treatment, Prevention and Control
2. Various Authors 2008-2018 -- Studies on Cardiac Manifestations in Dengue
3. National Hospital for Tropical Diseases Vietnam 2008 -- Study on ECG in Dengue Patients