Frequency and Pattern of ECG Findings in Children with Confirmed Dengue Fever

Abstract

Background: Dengue fever is a major public health concern in Pakistan, particularly among children who are vulnerable to severe complications. Objective: To determine the frequency and pattern of ECG findings in children with confirmed dengue fever. Methodology: This cross-sectional study was conducted at the Department of Pediatric Medicine, Shalamar Hospital, Lahore, from 2 April to 2 June while enrolling 118 children aged 1–12 years with serologically confirmed dengue fever. Non-probability consecutive sampling was used. Patients with congenital or acquired heart disease were excluded. After informed consent, ECG was performed on all enrolled children using age-appropriate leads.  Results: The mean age of the children was 6.2 ± 3.1 years; 57.6% were male. ECG abnormalities were detected in 34 (28.8%) patients, while 84 (71.2%) had normal findings. The most common abnormalities were sinus bradycardia (10.2%) and sinus tachycardia (6.8%), followed by T-wave inversion (4.2%), ST-segment changes (3.4%), low-voltage QRS complexes (2.5%), prolonged PR interval (1.7%), and prolonged QT interval (1.7%). ECG abnormalities were more frequent in children aged ≤5 years (37.9% vs. 20.0%, p = 0.03) and in those with severe dengue (66.7% vs. 18.9% in uncomplicated dengue, p = 0.02). No significant difference was observed by gender (p = 0.85). Conclusion: A considerable proportion of children with dengue fever demonstrate ECG abnormalities, particularly younger patients and those with severe disease. Although largely transient, these findings highlight the need for routine ECG screening in hospitalized pediatric dengue patients to ensure timely recognition and management of cardiac involvement.