Year : 2017 | Volume
: 54 | Issue : 2 | Page : 177--182
Cardiovascular involvement in severe malaria: A prospective study in Ranchi, Jharkhand
Hemant Narayan Ray1, Darshit Doshi1, Appu Rajan1, Amit K Singh1, SB Singh1, MK Das2
1 Rajendra Institute of Medical Sciences (RIMS), Bariatu, Ranchi, India
2 National Institute of Malaria Research, Field Unit, Ranchi, India
Background & objectives: Malaria is considered as the most important parasitic disease of humans, causing serious illness that can be fatal, if not diagnosed and treated immediately. It is a multisystem disorder affecting nearly every system of the body. The aim of the present study was to evaluate the involvement of cardiovascular system in severe malaria using non-invasive methods.
Methods: This prospective study was conducted on patients of severe malaria who were admitted between June and November 2015 in the Department of Medicine, Rajendra Institute of Medical Sciences and Hospital, Ranchi, Jharkhand, India. A total of 27 cases (18 males and 9 females; age ranging between 15 and 70 yr) of severe malaria (P. falciparum 24; P. vivax 1; mixed 2) were diagnosed by microscopic examination of peripheral blood smear and bivalent rapid diagnostic test (RDT) kit. The assessment of cardiovascular system was done by clinical examination, chest X-ray, ECG and transthoracic echocardiography.
Results: In all, 7 (26%) patients were found to be suffering from circulatory failure, out of which one was P. vivax case and rest were cases of P. falciparum infection with high parasite density. One patient died due to cardiovascular collapse. ECG revealed sinus bradycardia [Heart rate (HR): 40–60] in 7% of the cases, extreme tachycardia (HR: 120–150) in 3.7% of cases and premature arterial ectopic with tachycardia in 3.7% of patients (p <0.05). The echocardiography findings were global hypokinesia with decreased left ventricular ejection fraction (<55%) in 11.1%, grade 1 left ventricular diastolic dysfunction in 3.7%, mild tricuspid regurgitation (TR) with mild pulmonary artery hypertension (PAH) in 3.7% and mild pericardial effusion in 3.7% of the cases. The ECG and echocardiography changes indicated myocardial involvement in severe malaria.
Interpretation & conclusion: The present study indicated involvement of cardiovascular system in severe malaria as evidenced from ECG and echocardiography. The study also revealed that cardiovascular instabilities are common in falciparum malaria, but can also be observed in vivax malaria.
Department of Medicine, Rajendra Institute of Medical Sciences (RIMS), Bariatu, Ranchi–834 009, Jharkhand
|How to cite this article:|
Ray HN, Doshi D, Rajan A, Singh AK, Singh S B, Das M K. Cardiovascular involvement in severe malaria: A prospective study in Ranchi, Jharkhand.J Vector Borne Dis 2017;54:177-182
|How to cite this URL:|
Ray HN, Doshi D, Rajan A, Singh AK, Singh S B, Das M K. Cardiovascular involvement in severe malaria: A prospective study in Ranchi, Jharkhand. J Vector Borne Dis [serial online] 2017 [cited 2020 Jan 26 ];54:177-182
Available from: http://www.jvbd.org/article.asp?issn=0972-9062;year=2017;volume=54;issue=2;spage=177;epage=182;aulast=Ray;type=0