Myocarditis Complicating Pregnancy in Dengue Hemorrhagic Fever- A Case Report

We report a case of dengue hemorrhagic fever (DHF) complicated by acute myocarditis and review the literature. A 28-year-old pregnent woman experienced DHF due to dengue virus serotype 3, complicated with acute myocarditis and acute pulmonary edema. Clinically this masqueraded as acute myocardial infarction, with an electrocardiographically depressed ST segment in precordial leads and elevated serum cardiac-specific troponin I level. Under supportive management, the patient recovered 6 days later. Clinical manifestations of cardiac complications varied considerably, from self-limiting tachybrady arrhythmia to severe myocardial damage, leading to hypotension and pulmonary edema. Although rare, a fatal outcome was reported in some cases of dengue with cardiac complications. Physicians should have a high index of suspicion for cardiac complications in patients with dengue illness in order to avoid preventable morbidity and mortality.