Severe Acute Global Systolic Dysfunction Secondary to Dengue Myocarditis: A Case Report

We describe the case of a 47-year-old woman with laboratory-confirmed dengue fever who developed acute myocarditis during the critical phase of illness. On presentation, along with her initial symptoms of fever, headache, and myalgia, she also reported central chest discomfort and exertional dyspnoea. A standard transthoracic echocardiogram demonstrated severe left ventricular systolic dysfunction with an ejection fraction of 20%. She was treated in the intensive care unit with cautious fluid because of the risk of volume overload in dengue with cardiac involvement. She was able to come off inotropes after the acute phase of illness, and echocardiography at the three-month follow-up revealed improved ejection fraction to 40% and resolution of symptoms. This case points out the need for early detection of myocardial involvement in dengue infection and the importance of judicious fluid management to avert cardiac decompensation and improve prognosis.