Cardiac diseases complicating community-acquired pneumonia

Abstract

Purpose of review: The aim is to evaluate basic mechanisms, prevalence, risk factors, outcomes, and potential treatments of cardiovascular events (CVEs) in patients with community-acquired pneumonia (CAP).

Recent findings: In this review, we present a new model to evaluate the pathophysiology of cardiac disease in patients with pneumonia based on plaque-related events, such as acute myocardial infarction, versus plaque-unrelated events, such as arrhythmias and heart failure. CAP increases the risk for both plaque-related and plaque-unrelated events with an absolute rate of CVE across different cohorts that varies broadly from 10 to 30%. These complications may happen among both ambulatory patients and inpatients, either on admission or during hospitalization, and/or after discharge. CVEs represent a major cause for increased mortality in CAP patients, contributing to more than 30% of deaths at long-term follow-up.

Summary: From a clinical perspective, especially during the first 24 h after hospitalization, CAP patients should be tested for the probability to have or develop during hospitalization a cardiac event. From a research point of view, there is an urgent need to prospectively evaluate cardioprotective interventions.