Electrocardiogram as a predictive tool for the severity and clinical course of pediatric dengue infections.
- Author:
Rigil Mariquieta Fe P. Siazon
;
Leah Patricia M. Arceo-Plucena
- Publication Type:Journal Article
- Keywords:
Electrocardiogram;
ECG;
dengue with warning signs
- MeSH:
Severe Dengue;
Bradycardia
- From:
The Philippine Children’s Medical Center Journal
2018;14(1):61-71
- CountryPhilippines
- Language:English
-
Abstract:
BACKGROUND:Dengue is a mosquito-borne viral disease that has been a global burden especially in
the tropical regions. Cardiac involvement has been discussed in several studies. This is a pilot study to
identify electrocardiogram abnormalities and correlate these with the severity of dengue illness.
OBJECTIVES:To evaluate the efficiency of electrocardiogram as a predictive tool for the severity and
clinical course of pediatric dengue infections.
METHODS:This prospective cohort study was conducted at the Philippine Children’s Medical Center
from August to October 2017. A total of 325 dengue consults were seen at the pediatric emergency room
during the study period. Of these, 66 pediatric patients fulfilled the inclusion criteria for this study. Serial
pediatric electrocardiograms (ECG) were performed on days 1, 7, and 14 afebrile. The ECGs were
interpreted according to rhythm, axis and duration of waveforms and intervals. These ECG interpretations
were subsequently correlated to the patients’ dengue severity and clinical course.
RESULTS:Rhythm abnormalities were found in 15 out of the 66 dengue patients for an overall
incidence of 23%. All the rhythms were benign and self-limiting, including sinus bradycardia,
tachycardia, and first-degree atrio-ventricular block. Majority of the dengue patients had sinus rhythm (42
of 66, 64%), and of these, 8 had heart rates at the lower limits of normal range for age (12%). 23 percent
of abnormal rhythms were detected on day 1 of illness. All rhythm abnormalities resolved by day 14 of
afebrile.
CONCLUSION:The series of ECG did not show clinically significant or life-threatening arrhythmias
during the patients’ dengue illness in this cohort. All arrhythmias were benign and self-limiting,
regardless of dengue severity. The ECG did not correlate well with and cannot be utilized to predict the
clinical course of the dengue illness.
RECOMMENDATIONS:A retrospective comparative study is recommended to determine
predictability of dengue severity using ECG. A bigger cohort of dengue patients may detect significant
arrhythmias not caught in this study.
- Full text:Electrocardiogram as a predictive tool.pdf
