{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T13:18:24Z","timestamp":1770815904824,"version":"3.50.1"},"reference-count":34,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,12,3]]},"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:p>Dengue is a viral disease that clinically presents with fever, thrombocytopenia-related haemorrhagic complications and shock in its severest form. This female patient in her 40s primarily presented to the emergency department of the cardiac centre as syncopal attacks with a complete atrioventricular block. Temporary cardiac pacing as an emergency procedure helped to maintain cardiac rhythm and haemodynamics. A history of recent onset fever helped us to suspect and confirmed by serology for dengue pathology. Normal sinus rhythm was restored after 2\u2009days, and we removed the temporary pacing. Cardiac arrhythmia did not recur in 6 months of follow-up. The aetiology for dengue-related cardiac arrhythmia is still not established. In the recovery phase from fever, complete heart block may show up as a primary presentation in the emergency. Its timely diagnosis and temporary pacing may allow spontaneous recovery. The inclusion of electrocardiography in dengue patient guidelines should help clinicians to dictate its treatment.<\/jats:p>","DOI":"10.1136\/bcr-2023-257833","type":"journal-article","created":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T03:45:32Z","timestamp":1704858332000},"page":"e257833","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Complete atrioventricular block\u2014an uncommon clinical presentation in an adult patient with proven dengue fever"],"prefix":"10.1136","volume":"17","author":[{"given":"Nilay","family":"Tripathi","sequence":"first","affiliation":[{"name":"Department of Cardiology, King George's Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2360-7580","authenticated-orcid":false,"given":"Akshyaya","family":"Pradhan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, King George's Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7519-4474","authenticated-orcid":false,"given":"Mukesh","family":"Tripathi","sequence":"additional","affiliation":[{"name":"Anaesthesiology, All India Institute of Medical Sciences - Mangalagiri, Mangalagiri, Andhra Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,1,9]]},"reference":[{"key":"2025082709153937000_17.1.e257833.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2010.06.011"},{"key":"2025082709153937000_17.1.e257833.2","doi-asserted-by":"crossref","unstructured":"Zaki SA , Shanbag P . Persistent thrombocytopenia following dengue shock syndrome. Indian J Pediatr 2009;76. doi:10.1007\/s12098-009-0108-z","DOI":"10.1007\/s12098-009-0108-z"},{"key":"2025082709153937000_17.1.e257833.3","first-page":"14","article-title":"A study on cardiac manifestations of dengue fever","volume":"67","author":"Datta","year":"2019","journal-title":"Assoc Physicians India"},{"key":"2025082709153937000_17.1.e257833.4","first-page":"e146","article-title":"Spontaneous resolution of sinoatrial exit block and atrioventricular dissociation in a child with dengue fever","volume":"51","author":"Kaushik","year":"2010","journal-title":"Singapore Med J"},{"key":"2025082709153937000_17.1.e257833.5","doi-asserted-by":"crossref","first-page":"866","DOI":"10.4070\/kcj.2016.46.6.866","article-title":"Complete heart block in association with dengue hemorrhagic fever","volume":"46","author":"Virk","year":"2016","journal-title":"Korean Circ J"},{"key":"2025082709153937000_17.1.e257833.6","first-page":"569","article-title":"Transient ventricular arrhythmia as a cardiac manifestation in dengue haemorrhagic fever--a case report","volume":"28","author":"Chuah","year":"1987","journal-title":"Singapore Med J"},{"key":"2025082709153937000_17.1.e257833.7","first-page":"611","article-title":"Dengue myocarditis","volume":"35","author":"Promphan","year":"2004","journal-title":"Southeast Asian J Trop Med Public Health"},{"key":"2025082709153937000_17.1.e257833.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2008.05.023"},{"key":"2025082709153937000_17.1.e257833.9","first-page":"11","article-title":"Dengue fever: transient variable AV conduction block (2:1 with Mobitz type I second degree) during recovery phase","volume":"69","author":"Singh","year":"2021","journal-title":"J Assoc Physicians India"},{"key":"2025082709153937000_17.1.e257833.10","first-page":"642","article-title":"Morbitz type I second degree AV block during recovery from dengue hemorrhagic fever","volume":"31","author":"Khongphatthallayothin","year":"2000","journal-title":"Southeast Asian J Trop Med Public Health"},{"key":"2025082709153937000_17.1.e257833.11","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-5273(98)00008-4"},{"key":"2025082709153937000_17.1.e257833.12","first-page":"477","article-title":"Disturbi Della Conduzione Atrio-Ventricolare in Pazienti Colpiti DA Dengue Emorragica","volume":"34","author":"Donegani","year":"1986","journal-title":"Minerva Cardioangiol"},{"key":"2025082709153937000_17.1.e257833.13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3156.2007.01891.x"},{"key":"2025082709153937000_17.1.e257833.14","doi-asserted-by":"crossref","first-page":"6553","DOI":"10.4103\/jfmpc.jfmpc_345_22","article-title":"Myopericarditis - a catastrophic complication of dengue fever","volume":"11","author":"Giri","year":"2022","journal-title":"J Family Med Prim Care"},{"key":"2025082709153937000_17.1.e257833.15","doi-asserted-by":"crossref","DOI":"10.1186\/s13104-015-1036-9","article-title":"Complete heart block in dengue complicating management of shock due to both bleeding and leakage: a case report","volume":"8","author":"Navinan","year":"2015","journal-title":"BMC Res Notes"},{"key":"2025082709153937000_17.1.e257833.16","first-page":"289","article-title":"A clinical and epidemiological study of an epidemic of febrile illness with haemorrhagic manifestations which occurred at Kanpur, India, in 1968","volume":"43","author":"Chaturvedi","year":"1970","journal-title":"Bull World Health Organ"},{"key":"2025082709153937000_17.1.e257833.17","doi-asserted-by":"crossref","first-page":"350","DOI":"10.3201\/eid1402.070401","article-title":"Dengue and relative bradycardia","volume":"14","author":"Senanayake","year":"2008","journal-title":"Emerg Infect Dis"},{"key":"2025082709153937000_17.1.e257833.18","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/1755-7682-7-28","article-title":"Ventricular trigeminy in a patient with serologically confirmed dengue haemorrhagic fever","volume":"7","author":"Matthias","year":"2014","journal-title":"Int Arch Med"},{"key":"2025082709153937000_17.1.e257833.19","first-page":"362","article-title":"Dengue fever: an additional cause for bradycardia","volume":"62","author":"Sharda","year":"2014","journal-title":"J Assoc Physicians India"},{"key":"2025082709153937000_17.1.e257833.20","doi-asserted-by":"crossref","first-page":"S194","DOI":"10.1016\/j.ihj.2016.03.023","article-title":"High degree atrioventricular block with ventricular asystole in a case of dengue fever","volume":"68","author":"Dhariwal","year":"2016","journal-title":"Indian Heart J"},{"key":"2025082709153937000_17.1.e257833.21","unstructured":"Pol H , Mattsson G , Razmi R , et al . Dengue Feber Orsakade Arytmi [Dengue caused life-threatening arrhythmia]. Lakartidningen September 2020."},{"key":"2025082709153937000_17.1.e257833.22","first-page":"171","article-title":"Asymptomatic myocardial involvement in acute dengue virus infection in a cohort of adult Sri Lankans admitted to a tertiary referral centre","volume":"14","author":"Ravindral","year":"2007","journal-title":"Br J Cardiol"},{"key":"2025082709153937000_17.1.e257833.23","first-page":"418","article-title":"Acute atrial fibrillation during dengue hemorrhagic fever","volume":"7","author":"Horta Veloso","year":"2003","journal-title":"Braz J Infect Dis"},{"key":"2025082709153937000_17.1.e257833.24","doi-asserted-by":"publisher","DOI":"10.3201\/eid1304.061212"},{"key":"2025082709153937000_17.1.e257833.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.trstmh.2007.02.021"},{"key":"2025082709153937000_17.1.e257833.26","first-page":"59","article-title":"Myocardial dysfunction in children with Dengue Haemorrhagic fever","volume":"11","author":"Kabra","year":"1998","journal-title":"Natl Med J India"},{"key":"2025082709153937000_17.1.e257833.27","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1007\/s00134-003-1671-9","article-title":"Hemodynamic profiles of patients with dengue hemorrhagic fever during toxic stage: an echocardiographic study","volume":"29","author":"Khongphatthanayothin","year":"2003","journal-title":"Intensive Care Med"},{"key":"2025082709153937000_17.1.e257833.28","doi-asserted-by":"publisher","DOI":"10.1097\/01.PCC.0000288672.77782.D4"},{"key":"2025082709153937000_17.1.e257833.29","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1179\/1465328111Y.0000000008","article-title":"Spectrum of cardiac rhythm abnormalities and heart rate variability during the convalescent stage of dengue virus infection: a Holter study","volume":"31","author":"La-Orkhun","year":"2011","journal-title":"Ann Trop Paediatr"},{"key":"2025082709153937000_17.1.e257833.30","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.1993.48.324"},{"key":"2025082709153937000_17.1.e257833.31","doi-asserted-by":"publisher","DOI":"10.1111\/j.1348-0421.1996.tb01110.x"},{"key":"2025082709153937000_17.1.e257833.32","doi-asserted-by":"publisher","DOI":"10.1016\/j.trstmh.2007.06.019"},{"key":"2025082709153937000_17.1.e257833.33","doi-asserted-by":"publisher","DOI":"10.1016\/j.femsim.2004.11.012"},{"key":"2025082709153937000_17.1.e257833.34","doi-asserted-by":"publisher","DOI":"10.1002\/rmv.507"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2023-257833","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:15:50Z","timestamp":1756311350000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2023-257833"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":34,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1,9]]},"published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1136\/bcr-2023-257833"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2023-257833","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]}}}