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title:A Study on Cardiovascular Manifestation in Leptospirosis Cases in A Tertiary Care Hospital of Surat City

Author:Prakash T Chand, Vivek R Garg, Mithram Z Wadia

Keywords:Leptospirosis, Cardiovascular Manifestation, 2D Echo

Type:Original Article

Abstract:Background: Despite the fact that as many as 20% of patients may have associated cardiac involvement, these manifestations are seldom discussed in reviews on the clinical aspects. The present study has been carried out to know the involvement of cardiovascular system as indicator and mortality in leptospirosis. Methodology: The present study was carried out in Govt Medical College and New Civil Hospital, Surat during outbreak of Leptospirosis where all the patients with clinical suspicion of Leptospirosis were screened by IgM anti leptospira antibody ELISA (SERION ELISA), CK-MB levels, ECG changes and 2D ECHO changes. Results: It is seen that Myocarditis is maximum in more than 56 years which is about 66.6%. Out of 35 patients who were investigated with 2D echo, 18 patients (51.4%) had abnormal 2D ECHO findings. In the present study 18 patients had 2D ECHO changes in the form of reduced ejection fraction, regional wall abnormality, pericardial effusion and valvular abnormality. As the Ejection Fraction decreases the mortality increases. In EF 40-50% non survivors are 28.6%, EF 30-40% non survivors is 62.5% and EF less than <30 the mortality is 80%. Conclusion: Cardiovascular involvement is seen in 37.1% of patients in the form of ECG changes, hypotension and ECHO changes. Of these patients with cardiovascular involvement showed that there were functional changes but no organic changes in form of chamber enlargement or valvular involvement.

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