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Case Reports
. 2012 Nov 27:2012:bcr2012007275.
doi: 10.1136/bcr-2012-007275.

Malaria and the heart

Smitha Bhat  1 , Jayaprakash Alva, Krithika Muralidhara, Sayid Fahad
Affiliations
Case Reports

Malaria and the heart

Smitha Bhat et al. BMJ Case Rep. .

Abstract

A 40-year-old healthy manual labourer from a malaria endemic area with no known risk factors for atherosclerotic coronary vascular disease was admitted to our hospital with a history of fever with chills and rigours. Physical examination revealed tachypnoea and icterus. Peripheral smear showed trophozoites of Plasmodium vivax and thrombocytopaenia. The patient was administered artesunate. Six hours after admission, he complained of severe substernal chest pain. A 12-lead ECG revealed ST elevations in leads I, II and aVL. Troponin T and creatine kinase MB were elevated and the random blood sugar was 49 mg%. Echocardiogram revealed left ventricle lateral wall hypokinesia. Hypoglycaemia was corrected. A provisional diagnosis of acute coronary syndrome as a complication of malaria or its treatment was made. He was treated with low molecular weight heparin and nitrates. The patient improved symptomatically. A repeat ECG was normal.

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Figures

Figure 1
Figure 1
ECG showing ST elevation in leads I and II.
Figure 2
Figure 2
ECG showing ST elevation in lead aVL.
Figure 3
Figure 3
ECG showing reversion of ST elevation in lead I.
Figure 4
Figure 4
ECG showing reversion of ST elevation in Lead II.
Figure 5
Figure 5
Peripheral smear showing Plasmodium vivax and thrombocytopaenia.
Figure 6
Figure 6
Peripheral smear showing Plasmodium vivax and thrombocytopaenia.
See this image and copyright information in PMC

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