Mobitz type I atrio-ventricular block in dengue myocarditis, requiring temporary pacing

Area of Science:

• Cardiology
• Infectious Diseases
• Electrophysiology

Background:

• Dengue virus infection can lead to cardiac complications, including myocarditis.
• Atrio-ventricular (A-V) block is a recognized, though uncommon, manifestation of myocarditis.
• Mobitz type I A-V block is characterized by progressive lengthening of the PR interval.

Purpose of the Study:

• To report a unique case of dengue myocarditis presenting as Mobitz type I A-V block.
• To highlight the first documented instance of such a patient requiring temporary cardiac pacing.
• To explore the potential efficacy of corticosteroid therapy in managing dengue-associated myocarditis and A-V block.

Main Methods:

• Case report detailing clinical presentation, diagnostic workup, and management of a patient with dengue myocarditis.
• Electrocardiographic (ECG) monitoring to diagnose and assess the severity of atrio-ventricular block.
• Therapeutic intervention with methylprednisolone and temporary cardiac pacing as indicated.

Main Results:

• The patient presented with dengue fever complicated by myocarditis and Mobitz type I A-V block.
• Temporary cardiac pacing was required due to the severity of the atrio-ventricular block.
• Prompt administration of methylprednisolone led to an early positive clinical response.

Conclusions:

• Dengue myocarditis can manifest as significant atrio-ventricular block requiring advanced cardiac support.
• This case represents the first report of dengue-associated Mobitz type I A-V block necessitating cardiac pacing.
• Early administration of steroids may be a beneficial therapeutic strategy for dengue-induced myocarditis and associated conduction abnormalities.