European Journal of Cardiovascular Medicine

Objective: To study the incidence and outcome of cardiac manifestation in Acute febrile illness(AFI) with Dengue/ Leptospirosis/ Malaria/ Swine flu and to correlate organ dysfunction and mortality. Methods: This was a prospective observational study that included 187 AFI patients with laboratory confirmed Dengue/ Leptospirosis/ Malaria/ Swine flu admitted in tertiary care center. Demographic data, clinical presentation, investigations and outcomes were collected and analyzed. SOFA(Sequential organ failure assessment) score was used to assess outcome in patients with cardiac manifestation. Results: Total of 187 patients were included in this study. Mean age of patients was 26.5 years(SD8.4), 143(76.4%) were males and 44(23.5%) were females. 122 patients(65.2%) had ECG changes, out of which 86 patients(45.9%) had sinus tachycardia and rest 36 patients(19.2%) had ST-T changes or rhythm abnormalities. Of these 36 patients, 11 patients(5.88%) had 2D-Echo changes of hypokinesia and 27 patients(14.4%) had raised CPK-MB levels. 1 patient(0.5%) had LV hypokinesia without ECG manifestation. Mortality was higher among sinus tachycardia and additional ECG changes compared to sinus tachycardia alone(25% vs 3.4%,p<0.001). SOFA score >6 at zero hour and its increasing trends compared to decreasing or same trend predicted mortality(55.5% vs 1.85%,p<0.001). Conclusion: Incidence of cardiac manifestation in our study was 65.7% with 6.42% mortality. Sinus tachycardia is most common ECG manifestation. Mortality correlates better when Sinus tachycardia co-manifests with additional ECG changes. SOFA score >6 at zero hour has good mortality prediction as determined by the ROC (Receiver operative characteristic) curve. Increasing trends of SOFA score predicts mortality better than single initial score.