Cardiac Muscles Hit In Rare Case, Pumping Function Drops Sharply

The increasing danger posed by dengue became apparent again when a young Charni Road resident had a brush with death as the mosquitoborne ailment cut her heart function down to half, and almost pushed her towards a cardiac failure.

Pooja Parekh, 23, had been admitted to Bhatia Hospital with the usual symptoms of dengue — high fever, headache, chills and bouts of vomiting. Her condition suddenly started deteriorating three days into her hospitalization (see box). Her pulse dropped to less than 40 (normal being 60 to 100 per minute) — the first sign that the dengue infection was attacking her heart, said her treating doctor Pratik Samdani.

In one of the most unusual manifestations of dengue, her heart function soon dropped to 35% indicating that her heart muscles were taking a beating. She was immediately shifted to the ICU. Her condition was diagnosed as cardiomyopathy, commonly understood as inflammation of the heart muscles.

Medical literature says cardiac complications in dengue are not common, and only a handful of cases have been reported in the books so far. The mosquito–borne viral disease commonly affects platelets and the liver. Lately, dengue has also been affecting kidney functions.

"The dengue infection, which in Parekh’s case was arbo virus, releases inflammatory cells into the body. When the cells enter the heart muscles, they weaken it and mess with its pumping ability," explained Samdani. In certain cases, the damage to the patient’s heart is so immense that they have to permanently use a pacemaker.

A cardiologist from the civic–run KEM Hospital said not many physicians are able to pick up cardiomyopathy at the right time, which could lead to fatalities. "Dengue can cause such complications which is why patients should not delay visiting a doctor," he added.

Dengue’s increased incidence and severity continue to puzzle experts. The closest explanation given is circulation of its virulent type, DEN–2. At the national level, dengue cases had jumped to a humongous 50,222 cases last year, an almost 166% increase from 2011.

Mumbai, too, had recorded a 142% increase in dengue cases in 2012 compared to the previous year. This year, one–third of all dengue cases reported in the state have been detected in the city. So far, around 270 cases have been reported this year but luckily no fatalities.