Myocarditis mimicking a complete heart block in heart failure with reduced ejection fraction

Abstract

Background: In a arsenal of investigations a ecg can be of the most confusing one. Myocarditis is a inflammatory stage of the heart which can mimic any ecg changes. Myocarditis even though has grave acute prognosis if treated acutely has very minimal effect on patients quality of life. Case presentation: Here is a case of 32 year old man presenting with breathlessness, sever left sided chest pain, fever and blood in stools with severe joint pain. patient is a known case of diabetes and was on insulin belonging to lower socio economic status.ECG showed complete heart block and  Patient was taken up for angio and a temporary pace maker was implanted. Blood culture and viral markers were sent which came out to be positive for dengue fever. Conclusion: In a myraid of changes that a ecg can offer a common public health disease can mimic a cardiac condition with a poor diagnosis. The above case discussed is one example of it. Here a case of dengue myocarditis which itself has a grave prognosis but with active and agressive management is curable and the presentation of the which was that of a complete heart block. The above case discussed also points at the need for a uniform and guideline based diagnosis and management of myocarditis.