Heart damage in malaria: systematic literature review

Abstract

Context and objective. Cardiac involvement in malaria is often overlooked or underreported, and is generally not reported as a common complication. The objective of this systematic review was to describe cardiac involvement encountered in malaria. Methods. A systematic review was conducted using the PRISMA methodology, and research articles were analyzed and evaluated according to the five phases developed by Arksey and O’Malley. Results. Twenty-three studies were included (11 case reports, 1 retrospective study, 6 prospective observational studies, 2 case-control studies, 2 comparative studies, 1 cohort study). Of the 11 case reports, 5 reported myocardial involvement, 4 reported pericardial involvement, 1 cardiac tamponade, and 1 coronary syndrome. Seven reported Plasmodium falciparum infection, 3 Plasmodium vivax infection, and 1 mixed infection. Other studies reported elevated cardiac biomarkers (NT-proBNP, H-FABP, Myoglobin, Troponin T, CK-MB), electrocardiogram abnormalities (sinus tachycardia, PR and ST segment abnormalities, QTc prolongation), and echocardiographic abnormalities (pericardial effusion, signs of myocardial involvement) in some subjects with malaria, especially in its severe form. P. falciparum and vivax were also the species encountered. The cohort study reported that P. falciparum infection was associated with an increased risk of heart failure (HR: 1.64 [1.14-2.36], P = 0.008). Conclusion. In the context of multisystem involvement during malaria, cardiac involvement, particularly myocardial and pericardial, can be encountered. Received: July 31st, 2024Accepted: April 16th, 2025https://dx.doi.org/10.4314/aamed.v18i3.20