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

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.