Key result
Dengue shock syndrome is linked to troponin elevation in ~75% of patients.
Why the study?
Although dengue shock syndrome is largely attributed to capillary leakage, recent studies suggest cardiac involvement may contribute. This study sought to assess the prevalence of overt and subclinical cardiac manifestations in dengue fever.
Cross-Sectional (n=110)
No
Absolute Event Rate: 87.5% vs 39.5%
Cardiac involvement, evidenced by elevated cardiac biomarkers (troponin I and CKMB), is highly prevalent in patients with dengue shock syndrome and may contribute to hemodynamic instability.
Cardiac biomarker screening may aid dengue shock syndrome assessment; extends prior observations but leaves open causal role and management implications.
Background: The highest incidence of dengue fever (DF) is seen in Southeast Asia, India, and the American tropics. Arboviruses represent a serious public health problem in tropical and subtropical regions of the world. Although dengue shock syndrome (DSS) has been attributed largely to decreased intravascular volume due to capillary leakage of plasma into the interstitial space, a few recent studies have reported that it may be due to cardiac involvement. Hence, the present study was planned to assess the cardiac manifestations of DF and to identify subclinical/latent cardiac involvement. Aims and Objectives: To study was to evaluate the various cardiac manifestations of DF along with its prevalence. Materials and Methods: This descriptive cross-sectional study evaluated the prevalence and severity correlation of cardiac manifestations in dengue fever patients at a rural tertiary care center between January and December 2025. A total of 110 patients aged 13 years and older with confirmed dengue serology were enrolled after providing written informed consent. The study excluded individuals with pre-existing heart conditions, electrolyte imbalances, mixed infections, or medications affecting heart rate and rhythm. Data collection involved detailed clinical histories, daily vital sign monitoring, complete blood counts, cardiac enzyme assays, electrocardiograms, and 2D echocardiograms conducted after fever resolution. Cardiac involvement was identified through rhythm disturbances, enzyme elevations, and structural or electrical abnormalities, with patients classified according to WHO criteria following ethical approval. Results: In this study, out of the eight patients with DSS, six patients (75%) had positive troponin I. Eight patients were found to have DSS with 87.5% of them having raised CKMB levels compared to 42.3% and 39.5% in dengue hemorrhagic fever and DF, respectively. Conclusion: Cardiac involvement in dengue can contribute to hemodynamic instability in dengue patients. ECG can prove a useful tool, especially in patients with hemodynamic instability to plan for more efficient management.
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Chaudhari et al. (2026) conducted a cross-sectional in Dengue fever (n=110). Dengue shock syndrome (DSS) vs. Dengue hemorrhagic fever (DHF) and dengue fever (DF) was evaluated on Elevated CK-MB levels and positive troponin I. Dengue shock syndrome was associated with positive troponin I in 75% of patients and raised CK-MB in 87.5%, compared to 42.3% in dengue hemorrhagic fever and 39.5% in dengue fever.
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