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Zika virus infection affects more than 80 countries in the world, mainly those with a tropical climate. Although the most frequent clinical presentation is characterized by rash, conjunctivitis, myalgia, arthralgia and fever, in some cases it is associated with cardiovascular manifestations, such as myocarditis, pericarditis, heart failure and arrhythmias. Furthermore, maternal transmission of the virus generates congenital Zika syndrome, which is associated with cardiac septal defects. Early recognition and treatment of Zika's cardiovascular complications are essential to reduce morbidity and mortality in these patients. There is no specific antiviral treatment or vaccine in humans, so the development of public health strategies to prevent its transmission is of paramount importance. The "Neglected Tropical Diseases and other Infectious Diseases" (NET-Heart project) is an initiative to systematically review all these devastating endemic conditions affecting the heart to spread knowledge and propose algorithms for early diagnosis and treatment., Competing Interests: Declaration of Competing Interest None., (Copyright © 2020. Published by Elsevier Inc.)

Dengue is a neglected viral arthropod-borne tropical disease transmitted by the bite of infected Aedes spp. mosquitoes. It is responsible for a significant global burden of disease and corresponding socio-economic implications. There are four different virus serotypes, all of which are found predominantly in countries with tropical climates. Patients with dengue may present with cardiovascular (CV) manifestations, contributing to associated death and disability. A systematic review was conducted to identify CV manifestations of dengue, wherein 30 relevant studies were identified in the MEDLINE and PubMed databases. CV complications of dengue include rhythm abnormalities, hypotension, myocarditis, pericarditis and deterioration in myocardial function. Prompt recognition and treatment of CV complications of dengue are essential to reduce morbidity and mortality in these patients, who are at risk of progressing to cardiogenic shock and heart failure.

Chagas' disease and Lyme disease are two endemic, vector-borne zoonotic infectious diseases that impact multiple organ systems, including the heart. Chagas' cardiomyopathy is a progressive process that can evolve into a dilated cardiomyopathy and heart failure several decades after the acute infection; in contrast, although early-disseminated Lyme carditis has been relatively well characterized, the sequelae of Lyme disease on the heart are less well-defined. A century of research on Chagas' cardiomyopathy has generated compelling data for pathophysiological models, evaluated the efficacy of therapy in large randomized controlled trials, and explored the social determinants of health impacting preventative measures. Recognizing the commonalities between Chagas' disease and Lyme disease, we speculate on whether some of the lessons learned from Chagas' cardiomyopathy may be applicable to Lyme carditis., (Copyright © 2020. Published by Elsevier Inc.)

Introduction: Zika pandemic remains a formidable challenge to medicine and has been considered the worst outbreak of the century. There are only a few reports of cardiovascular manifestation of Zika. Objective: This study sought to describe Zika myocarditis manifesting with coexisting acute atrial and ventricular arrhythmias and pruriginous " itchy" rash. Methods: We enrolled 16 cases that developed acute Zika myocarditis within one week of disease onset in a prospective observational multicenter study. Clinical and laboratory evaluation including Zika confirmation, ECG, echocardiogram, Holter, coronary arteriography (2) and cardiac MRI were performed. Results: Of the 16 patients, 10 (63%) were female with a mean age of 52 ± 15, 10 (63%) developed simultaneously acute atrial and ventricular arrhythmias and itchy rash. The new arrhythmias included atrial fibrillation in 7 patients, non-sustained atrial tachycardia in 10 cases, ventricular tachycardia in 5 patients, complex ventricular arrhythmias in 10 cases. Two patients died suddenly within the first week of the disease. Acute heart failure was present in 7 cases, 6 with low ejection fraction. Conclusion: Zika myocarditis can be lethal and severe, manifesting with coexisting acute atrial and ventricular arrhythmias and itchy rash. Physicians should be aware of this combination and complication. [ABSTRACT FROM AUTHOR]

The burden of cardiovascular diseases is sharply rising in low- and middle-income countries (LMICs). Along with the increasing rates of cardiovascular risk factors in these regions, there is a growing recognition of the contribution of neglected tropical diseases and other infections. Several cardiac implications of these infections have been reported but have not yet been validated by robust population data. This is in part due to limited access to health care and insufficient data collection infrastructure in many LMICs. Therefore, the true impact of these infections on the cardiovascular system may be underestimated, because of both underdiagnosis and underreporting bias. There is an urgent need to thoroughly delineate the cardiac impact of these conditions with elevated prevalence in LMICs and to propose strategies to reduce the negative consequences of these diseases in health systems with limited resources. [Display omitted] • Tropical infections can adversely affect the cardiovascular system in multiple ways, and their impact may be underestimated. • Better understanding of the cardiovascular effects of tropical infectious diseases can facilitate development of preventive, diagnostic, and therapeutic strategies. • Collaboration between public and non-governmental sectors is crucial to reducing the detrimental impact of tropical infectious diseases. [ABSTRACT FROM AUTHOR]

As one of the tropical diseases, malaria is endemic in developing countries. Severe malaria, mainly caused by the Plasmodium falciparum parasite, can result in life-threatening complications. Traditionally, cardiac involvement has not been included as a frequent cause of morbidity and mortality. This could be due to under-reporting or underdiagnosing. Specific cardiovascular (CV) complications include electrocardiogram abnormalities, myocarditis, pericarditis, pericardial effusion, ischemic disease, and heart failure. According to the data analyzed, CV manifestations can lead to severe consequences. Possible theories related to the pathophysiological mechanisms related to CV compromise include an imbalanced pro-inflammatory cytokine response and/or erythrocyte sequestration by increased cytoadherence to endothelium. Although there is a paucity of data regarding cardiac manifestations of malaria, an algorithm for appropriate use of diagnostic tools to assess cardiac involvement has been developed in this paper. Furthermore, it is important to note that typical antimalarial treatment regimens can have fatal cardiac side-effects. [ABSTRACT FROM AUTHOR]