1 Universidad del Sinu, Cartagena.
2 General Physician, Corporación Universitaria Rafael Nuñez, Cartagena.
3 Universidad de Sucre, Sincelejo.
4 Universidad Simon Bolivar, Barranquilla.
5 Universidad del Norte, Barranquilla.
6 Universidad Libre, Barranquilla.
World Journal of Advanced Research and Reviews, 2026, 29(01), 1938-1943
Article DOI: 10.30574/wjarr.2026.29.1.0263
Received on 23 December 2025; revised on 28 January 2026; accepted on 31 January 2026
Introduction: Relative bradycardia, also known as Faget's sign, occurs when the heart rate does not increase in proportion to fever. Although it has been described for years in different infections, in daily practice it is rarely sought systematically and its clinical usefulness is not always taken into account.
Objective: To determine whether relative bradycardia is useful in guiding diagnosis and prognosis in patients with febrile syndrome.
Methods: A systematic review of the literature was conducted in PubMed, Scopus, Web of Science, and SciELO. Articles published between 1992 and 2024 that evaluated the relationship between body temperature and heart rate were included.
Results: Twenty-four studies were included. Relative bradycardia was most frequently described in typhoid fever, dengue, legionellosis, and leptospirosis. Most studies showed high specificity, although sensitivity was variable. Its identification helped to better guide diagnosis, especially in resource-limited settings. Variability was also found between studies.
Conclusions: Relative bradycardia is a clinical sign that can be useful in daily practice but is underutilized. Its value could be improved by standardizing diagnostic criteria and conducting more prospective studies.
Relative bradycardia; Faget's sign; Fever; Infectious diseases; Systematic review
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Cinthya Montilla Coronel, Isaac Dager Vergara, Xiomara Fadul Buelvas, Orlando Avila Ramirez, Efrain del Valle Miranda, Maria Menco Meza, Alexis Rangel Mendez, Antonio Alvarez Fortich and lauren Marenco Garcia. Beyond slow pulse: Systematic review of relative bradycardia in clinical practice. World Journal of Advanced Research and Reviews, 2026, 29(01), 1938-1943. Article DOI: https://doi.org/10.30574/wjarr.2026.29.1.0263.
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