Cardiovascular involvement in severe malaria: A prospective study in Ranchi, Jharkhand

Area of Science:

• Cardiology
• Infectious Diseases
• Parasitology

Background:

• Malaria is a life-threatening parasitic disease affecting multiple organ systems.
• Early diagnosis and treatment are crucial for managing severe malaria.
• The cardiovascular system's involvement in severe malaria requires further investigation.

Purpose of the Study:

• To assess cardiovascular system involvement in severe malaria patients.
• To utilize non-invasive methods for cardiovascular evaluation.
• To identify specific cardiovascular abnormalities associated with severe malaria.

Main Methods:

• Prospective study of 27 severe malaria patients (June-November 2015).
• Diagnosis confirmed by peripheral blood smear microscopy and rapid diagnostic tests (RDT).
• Cardiovascular assessment included clinical examination, chest X-ray, ECG, and transthoracic echocardiography.

Main Results:

• Circulatory failure observed in 26% of patients, primarily with Plasmodium falciparum infection.
• ECG showed sinus bradycardia (7%), tachycardia (3.7%), and ectopic beats (3.7%).
• Echocardiography revealed decreased left ventricular ejection fraction (11.1%), diastolic dysfunction (3.7%), and pulmonary artery hypertension (3.7%).

Conclusions:

• The cardiovascular system is involved in severe malaria, confirmed by ECG and echocardiography findings.
• Myocardial involvement is indicated by ECG and echocardiographic changes.
• Cardiovascular instabilities are frequent in Plasmodium falciparum malaria and can also be seen in Plasmodium vivax malaria.