Acute Cardiac Events in Patients With Severe Limb Infection

Area of Science:

• Cardiology
• Infectious Diseases
• Vascular Surgery

Background:

• Infections are increasingly recognized as triggers for acute cardiac events.
• Previous research links systemic infections (influenza, pneumonia, bacteremia) to cardiovascular complications.
• The specific association between foot infections and cardiac events remains less understood.

Purpose of the Study:

• To investigate the relationship between severe foot infections and acute cardiac events.
• To determine the incidence of myocardial infarction, arrhythmia, and congestive heart failure in patients with foot infections.
• To assess the impact of these cardiac events on patient survival.

Main Methods:

• Retrospective analysis of 318 episodes of deep soft tissue foot infections, gangrene, or osteomyelitis in 274 patients.
• Patients were referred to a tertiary center's vascular surgery service.
• Cardiac events and patient survival rates were systematically recorded and analyzed.

Main Results:

• A total of 24 acute cardiac events occurred in 6.6% of foot infection episodes.
• These included 11 new myocardial infarctions, 8 cases of congestive heart failure, and 5 new arrhythmias.
• Tachycardia and systemic inflammatory response syndrome were significantly associated with cardiac events (P < .05).
• One-year survival was markedly lower for patients with cardiac events (50.4%) compared to those without (91.7%, P < .0015).

Conclusions:

• Acute cardiac complications are a significant and not uncommon occurrence in patients with severe foot infections.
• These cardiac events are associated with a substantially increased 1-year mortality risk.
• Healthcare providers (primary care, cardiology, vascular, orthopedic surgery) should maintain a high index of suspicion for cardiac events in these patients.