P2923Sudden cardiac death, heart failure and arrhythmias due to acute zika myocarditis

Abstract

Background: Zika virus infection (ZIKV) is a mosquito-borne disease that has been considered the worst outbreak of the 21ST Century and has become a global Health Hazard. There is only one report of Heart Failure (HF) and arrhythmias associated with ZIKV and none of sudden cardiac death (SCD). Purpose(s): This study sought to describe severe cardiovascular manifestations of Zika myocarditis. Method(s): We enrolled 13 cases that developed acute myocarditis within 10 days of disease onset in a prospective observational multicenter study. Acute ZIKV was confirmed with specific PCR and IgM antibody. Potentially simultaneous infection including Dengue, Chikungunya and other virus or parasitic infections were ruled out. Result(s): Of the 13 patients 8 (69%) were females with a mean age of 53+/-17 years. Two patients died suddenly within the first week of the disease, both had previous history of Dengue. Acute HF was present in 7 cases, 6 presented with low ejection fraction and one with preserved ejection fraction and moderate to severe pericardial effusion. New arrhythmias were detected in 12 patients including new onset atrial fibrillation in 4 cases, atrial tachycardia in 6 cases, ventricular arrhythmias in 4 patients and new Left bundle branch block in 1 patient. Conclusion(s): Zika myocarditis can be lethal and severe with HF and serious arrhythmias. Physicians should be aware of these complications. This is the first report of SCD due to Zika Myocarditis. (Figure Presented).