Key result
Myocarditis affects ~4% of patients with dengue fever and tracks with troponin elevation.
Why the study?
The frequency of myocarditis among patients with dengue fever and the clinical factors associated with myocarditis were not well defined in this population.
Cross-Sectional (n=387)
No
Myocarditis occurs in approximately 4.1% of patients hospitalized with dengue fever and is significantly associated with comorbidities like hypertension and diabetes, as well as objective markers of cardiac and systemic dysfunction.
Supports cardiac evaluation in dengue with these markers; leaves open prospective validation before practice change.
Objectives: The study aims to determine the frequency of myocarditis among patients presenting with dengue fever and identify the clinical factors associated with myocarditis at a tertiary care hospital in Karachi. Material and Methods: This descriptive cross-sectional study was conducted at the Department of Internal Medicine, Memon Medical Institute, Karachi (22 September 2025 to 22 March 2026). A total of 387 patients aged 15–70 years with confirmed dengue fever were enrolled through non-probability consecutive sampling. Patients with pre-existing cardiac diseases, congenital heart defects, active viral infections other than dengue, pregnancy, and severe co-morbid illnesses were excluded. Demographic and clinical data were recorded on a structured proforma. All patients underwent electrocardiography and laboratory investigations including serum troponin I, serum bicarbonate, and serum creatinine. Echocardiography was performed when clinically indicated. Data were analyzed using SPSS version 26. Associations between myocarditis and study variables were assessed using the Chi-square test, with p≤0.05 considered statistically significant. Results: The mean age of the participants was 36.8±14.2 years, and 232 (59.9%) were males. Myocarditis was identified in 16 (4.1%) patients. Duration of fever (p=0.049), hospital stay duration (p<0.001), elevated troponin I (p<0.001), abnormal echocardiography (p<0.001), hypertension (p=0.006), diabetes mellitus (p=0.009), atrial fibrillation (p<0.001), low serum bicarbonate (p<0.001), and high serum creatinine (p<0.001) were significantly associated with myocarditis. Conclusion: Myocarditis was an uncommon complication of dengue fever. Several clinical and laboratory factors were significantly associated with myocarditis and may aid in its early identification and timely management.
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Afzal et al. (2026) conducted a cross-sectional in Dengue fever (n=387). Dengue fever was evaluated on Frequency of myocarditis. Myocarditis was identified in 4.1% of patients with dengue fever and was significantly associated with clinical factors such as elevated troponin I, abnormal echocardiography, and atrial fibrillation.
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