International Journal of Cardiovascular Sciences. 11/jul/2025;38:e20240191.

Intermittent Left Bundle Branch Block and Cardiac Memory in a Patient with Dengue Fever: A Case Report and Literature Review

Muchtar Nora Ismail Siregar , Jasmine Ibtisamah Alkatiri

DOI: 10.36660/ijcs.20240191

Abstract

Background:

Arrhythmias and Electrocardiography changes in Dengue Fever (DF) cases can mimic electrocardiogram (ECG) appearance of threatening clinical conditions such as myocardial ischemia, albeit no significant ischemic injury at the heart muscle.

Case Presentation:

We report a case of subsequent cardiac memory (CM) in a 50-year-old female with DF. A 12-lead ECG on admission revealed sinus rhythm with Left Bundle Branch Block (LBBB), and it resolved on day 4 of hospitalization. However, deep symmetric T wave inversions (TWI), which were later recognized as CM, occurred. The patient received treatment with Ringer’s lactate and paracetamol infusion. A routine 12-lead ECG performed on day 7 of hospitalization revealed the resolution of TWI and normal sinus rhythm.

Conclusion:

This case report highlights one intriguing phenomenon associated with LBBB in DF, which is CM TWI, where the T wave ‘remembers’ the direction of the QRS complex during prior abnormal ventricular activation. Due to its similarity with TWI caused by myocardial ischemia, understanding of this phenomenon may prevent unnecessary interventions.