Evaluation of cardiovascular status in severe leptospirosis

Objectives: To note incidence and profile of cardiac involvement in severe leptospirosis in South Gujarat. Methods: A study was carried out on twenty-five serologically proved leptospirosis patients referred to Government Medical College, New Civil Hospital, Surat between June 2002 to September 2002. In all the patients detailed history, physical examination and specific investigations were done to find out the incidence and profile of cardiac involvement in severe leptospirosis. Results: Out of twenty-five seropositive patients, 14(56%) had cardiovascular manifestations. Electrocardiography abnormalities were seen in 13(52%) patients. The commonest finding was first-degree AV block seen in 11(44%) patients followed by ST-segment depression in four (16%) patients, T-wave inversion in leads II, III and avF in two (8%) patients, corrected QT-interval prolongation in three (12%) patients and ventricular premature beats in two (8%) patients. Atrial fibrillation was seen in only one patient. Left ventricular function as assessed by two-dimensional echocardiography was normal in all patients. Conclusion: In cardiovascular involvement of leptospirosis, although electrocardiographic abnormalities were commonly seen, there was no left ventricular dysfunction.