Severe dengue with fulminant myocarditis and acute coronary syndrome in a young woman:case report.
Keywords:
Dengue; fulminant myocarditis; acute coronary, syndrome; cardiogenic shock.Abstract
Dengue is an endemic viral disease that is usually self-limited
but
may
progress
to
severe
organ
dysfunction.
Cardiovascular involvement is uncommon and can present as
myocarditis, arrhythmias, or a clinical picture mimicking
acute coronary syndrome. We report a 34-year-old woman
with hypertension and class II obesity with confirmed dengue
who developed intense abdominal pain, metabolic acidosis,
elevated troponin I and CK-MB, and ST-segment elevation
in leads V2–V4. Point-of-care echocardiography showed
apical hypokinesia and systemic venous congestion, raising
the differential diagnosis of fulminant myocarditis versus
acute myocardial infarction. Given the high bleeding risk
inherent to severe dengue, initial antiplatelet therapy was
withheld. Despite early transfer to a tertiary center, the patient
deteriorated rapidly, developing cardiogenic shock and
cardiac arrest with fatal outcome. This case highlights the
diagnostic and therapeutic challenges of dengue-related
myocardial injury and underscores the need for early
recognition and individualized management.
