Left ventricular pseudoaneurysm in dengue fever

Dengue fever is a disease with clinical manifestations ranging from asymptomatic infection to a severe disease. A 4-year-old boy was admitted with serologically proven dengue haemorrhagic fever, with clinical features of heart failure. ECG was suggestive of pericarditis (figure 1A); chest X-ray PA view showed cardiomegaly (figure 1B); echocardiography (figure 1C–E) and MRI (figure 1F) showed pericardial effusion with evidence of pseudoaneurysm of left ventricle. Mechanism of pseudoaneurysm was thought to be due to severe myocarditis which led to cardiac rupture and contained within the pericardium. As the relatives were not keen for a surgery, intensive supportive medical management of heart failure continued. Symptoms improved. Serial echo after 3 months (figure 2A, B) showed resolution of both pericardial effusion and pseudoaneurysm. A majority of patients with dengue fever have relatively benign disease course. Few patients develop severe clinical manifestations, including...

Source: Heart Asia - September 30, 2014 Category: Cardiology Authors: Madhavan, S., Narayanapillai, J. Tags: Images in cardiovascular medicine Source Type: research