Abstract 14717: Zika Myocarditis, Risk Factors, Prior Arbovirus Infection Brings Out the Worst

Introduction: Zika infection (ZIKV) is considered the worst epidemic of this century. Research on the relationship between ZIKV and myocarditis is lacking. Experimental animals infused with Dengue virus became more susceptible to disease and death from ZIKV. Objectives: This study sought to describe the risk factor that predisposes to ZIKAV Myocarditis. Methods: We enrolled 12 cases of Zika with new Myocarditis in a prospective observational multicenter study. Clinical and laboratory evaluation including Zika confirmation and other virus or parasitic infection, ECG, Echocardiogram, Holter, coronary arteriography (2) and cardiac MRI were performed. Results: Of the 12 patients 8 (75%) were females with a mean age of 51±17 years. New arrhythmias were detected in 11 patients including new onset atrial fibrillation in 4 cases, atrial tachycardia in 2 patients and new left bundle branch block in 1 case. New Heart Failure (HF) was present in 6 cases, 5 presented with low ejection fraction (EF) and 1 with preserved EF, preeclampsia and moderate to severe pericardial effusion. Five are hypertensive, 8 (75%) with history of Dengue infection (Dengue Ig G (+) and Ig M (-)) and one with past history of Chikungunya. Conclusions: The importance of awareness, Zika Myocarditis is more than a possibility. Prior Dengue infection and comorbidities enhance ZIKV infection and may increase the risk of developing myocarditis. Further studies are needed to define the incidence of cardiac involvement in Zika.