Dengue fever complicated with acute ST elevation myocardial infarction - a therapeutic conundrum: our experience from two cases

Authors

  • Maheshi Wijayabandara Registrar in Geriatric Medicine, University Medical Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka https://orcid.org/0000-0003-3350-7011
  • Devasmitha Wijesundara Registrar in Internal Medicine, University Medical Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka https://orcid.org/0000-0002-2503-3955
  • Champika Gamakaranage Consultant Physician and Senior Lecturer in Medicine, Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Sri Lanka https://orcid.org/0000-0001-6040-5649
  • Panduka Karunanayake Consultant Physician and Senior Lecturer in Medicine, Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Sri Lanka https://orcid.org/0000-0002-8102-6952
  • Shyam Fernando Professor in Medicine, Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Sri Lanka
  • Saroj Jayasinghe Chair Professor of Medicine, Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Sri Lanka https://orcid.org/0000-0003-1460-6073

DOI:

https://doi.org/10.3126/ajms.v12i2.30410

Keywords:

Dengue fever, acute coronary syndrome, ST elevation myocardial infarction, anti-platelets, anti-coagulation

Abstract

Dengue fever has a wide range of clinical manifestations from asymptomatic disease to complicated dengue haemorrhagic fever and dengue shock syndrome. Bleeding manifestations in dengue is well known but thrombotic events complicating dengue is uncommon. ST elevation myocardial infarction during dengue is rare and poses important management dilemma. At present, there is no consensus on how to manage this situation. We present two patients with dengue fever developing ST elevation myocardial infarction and our experience in the management. We suggest case-based management of acute coronary syndrome in dengue, guided by the degree of thrombocytopaenia and bleeding risk. Further studies are needed to include this into existing dengue management guidelines.

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Published

2021-01-01

How to Cite

Wijayabandara, M., Wijesundara, D., Gamakaranage, C., Karunanayake, P., Fernando, S., & Jayasinghe, S. (2021). Dengue fever complicated with acute ST elevation myocardial infarction - a therapeutic conundrum: our experience from two cases. Asian Journal of Medical Sciences, 12(1), 118–123. https://doi.org/10.3126/ajms.v12i2.30410

Issue

Section

Case Series