Letter to the Editor
Acute myocardial infarction secondary to infection by Plasmodium ovale
Infarto agudo de miocardio secundario a infección por Plasmodium ovale
Read
3
Timeswas read the article
1
Total PDF
2
Total HTML
Share statistics
array:24 [ "pii" => "S2387020620301017" "issn" => "23870206" "doi" => "10.1016/j.medcle.2019.03.041" "estado" => "S300" "fechaPublicacion" => "2020-04-24" "aid" => "4840" "copyright" => "Elsevier España, S.L.U.. All rights reserved" "copyrightAnyo" => "2019" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2020;154:325-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0025775319302544" "issn" => "00257753" "doi" => "10.1016/j.medcli.2019.03.025" "estado" => "S300" "fechaPublicacion" => "2020-04-24" "aid" => "4840" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2020;154:325-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al Editor</span>" "titulo" => "Infarto agudo de miocardio secundario a infección por <span class="elsevierStyleItalic">Plasmodium ovale</span>" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "325" "paginaFinal" => "326" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Acute myocardial infarction secondary to infection by <span class="elsevierStyleItalic">Plasmodium ovale</span>" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Lorena Martín Polo, Clara Crespillo-Andújar, Juan Ramón Rey Blas" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Lorena" "apellidos" => "Martín Polo" ] 1 => array:2 [ "nombre" => "Clara" "apellidos" => "Crespillo-Andújar" ] 2 => array:2 [ "nombre" => "Juan Ramón" "apellidos" => "Rey Blas" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2387020620301017" "doi" => "10.1016/j.medcle.2019.03.041" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020620301017?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775319302544?idApp=UINPBA00004N" "url" => "/00257753/0000015400000008/v1_202004110627/S0025775319302544/v1_202004110627/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2387020620301042" "issn" => "23870206" "doi" => "10.1016/j.medcle.2019.05.024" "estado" => "S300" "fechaPublicacion" => "2020-04-24" "aid" => "4940" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Med Clin. 2020;154:327" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in medicine</span>" "titulo" => "Pemphigoid gestationis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "327" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Penfigoide gestacional" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1134 "Ancho" => 850 "Tamanyo" => 98558 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Fernando García Souto, Sandra Cases Mérida, Jerónimo Escudero Ordoñez" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Fernando" "apellidos" => "García Souto" ] 1 => array:2 [ "nombre" => "Sandra" "apellidos" => "Cases Mérida" ] 2 => array:2 [ "nombre" => "Jerónimo" "apellidos" => "Escudero Ordoñez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0025775319304932" "doi" => "10.1016/j.medcli.2019.05.037" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775319304932?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020620301042?idApp=UINPBA00004N" "url" => "/23870206/0000015400000008/v1_202004190641/S2387020620301042/v1_202004190641/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2387020620300929" "issn" => "23870206" "doi" => "10.1016/j.medcle.2019.03.040" "estado" => "S300" "fechaPublicacion" => "2020-04-24" "aid" => "4843" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2020;154:324-5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Adrenal insufficiency secondary to topic clobetasol" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "324" "paginaFinal" => "325" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Insuficiencia suprarrenal secundaria a clobetasol tópico" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Juan Bertholle-Gil, Apolonia Gil-Palmer, Joana Nicolau-Ramis" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Juan" "apellidos" => "Bertholle-Gil" ] 1 => array:2 [ "nombre" => "Apolonia" "apellidos" => "Gil-Palmer" ] 2 => array:2 [ "nombre" => "Joana" "apellidos" => "Nicolau-Ramis" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775319302866" "doi" => "10.1016/j.medcli.2019.03.026" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775319302866?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020620300929?idApp=UINPBA00004N" "url" => "/23870206/0000015400000008/v1_202004190641/S2387020620300929/v1_202004190641/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Acute myocardial infarction secondary to infection by <span class="elsevierStyleItalic">Plasmodium ovale</span>" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "325" "paginaFinal" => "326" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Lorena Martín Polo, Clara Crespillo-Andújar, Juan Ramón Rey Blas" "autores" => array:3 [ 0 => array:3 [ "nombre" => "Lorena" "apellidos" => "Martín Polo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "Clara" "apellidos" => "Crespillo-Andújar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:4 [ "nombre" => "Juan Ramón" "apellidos" => "Rey Blas" "email" => array:1 [ 0 => "jreyblas@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Referencia de Medicina Tropical y del Viajero, Servicio de Medicina Interna, Hospital Universitario La Paz-Carlos III, IdiPAZ, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Infarto agudo de miocardio secundario a infección por <span class="elsevierStyleItalic">Plasmodium ovale</span>" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Malaria results in systemic involvement with varying degrees of severity, possibly even including heart damage.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> The few published data on cardiac involvement are mainly related to cases secondary to infection by <span class="elsevierStyleItalic">Plasmodium falciparum</span> and <span class="elsevierStyleItalic">Plasmodium vivax</span> (the most prevalent species).<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2,3</span></a> Because infection by <span class="elsevierStyleItalic">Plasmodium ovale</span> is the most uncommon cause of malaria in Central Africa (prevalence of 1%–10%), its cardiac involvement is even less known and described.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> We hereby present a case of acute myocardial infarction (AMI) following a malaria infection caused by <span class="elsevierStyleItalic">P. ovale</span>.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The patient is a 43-year-old man from Ivory Coast, with no cardiovascular risk factors, who visited the Tropical Medicine Unit 3 weeks after returning from a trip to his home country due to experiencing unmeasured dysthermia, joint pain, and night sweats. After performing a thick blood smear, which was negative, a polymerase chain reaction (PCR) malaria detection assay was requested, obtaining a positive result for <span class="elsevierStyleItalic">P. ovale</span>. Ten days after the first consultation (before starting the antimalarial treatment), he experienced central, oppressive chest pain at rest that radiated toward his left arm, lasted approximately 10<span class="elsevierStyleHsp" style=""></span>h, was not clearly modified by inspiration nor postural changes, and was not associated with dyspnea nor palpitations. Because of these symptoms, he was referred to the Emergency Room to undergo diagnostic studies.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The electrocardiogram (ECG) performed upon his arrival to this department revealed a diffuse, concave elevation of the ST segment in the lower leads and leads V2–V6 suggestive of pericarditis. In addition, the blood tests performed at the time revealed troponin I levels of 2.36<span class="elsevierStyleHsp" style=""></span>ng/ml at baseline and 6.11<span class="elsevierStyleHsp" style=""></span>ng/ml at 6<span class="elsevierStyleHsp" style=""></span>h (normal reference value: <0.04<span class="elsevierStyleHsp" style=""></span>ng/ml).</p><p id="par0020" class="elsevierStylePara elsevierViewall">With the presumptive diagnosis of acute myopericarditis, he was admitted to the Coronary Unit and administered treatment with anti-inflammatory drugs and atovaquone/proguanil, achieving quick clinical stabilization.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Apical hypokinesia with a normal global systolic function was also documented in an echocardiogram. Moreover, subsequent magnetic resonance imaging (MRI) of the heart showed signs of apical akinesia and late transmural contrast enhancement in the apex and lower apical region, but a central area with no enhancement possibly secondary to microvascular obstruction, thus suggesting a myocardial ischemic etiology.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Serial ECGs performed during the patient's stay at the hospital were reviewed, detecting early negativization of the T wave in leads II and V3–V6 and a persistent ST-segment elevation, which was more suggestive of an acute coronary syndrome than pericarditis. A coronary angiography guided by optical coherence tomography was performed, with no atherosclerotic coronary lesions being observed, considering which a fissure or rupture of an atheroma plate were consequently ruled out as a potential cause of these lesion. Also, given the absence of an embolic source, a resolved coronary embolism was also deemed unlikely and a possible microvascular obstruction secondary to the malaria infection was finally identified as the most likely cause of the apical infarction.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The patient's treatment at discharge consisted in the discontinuation of the anti-inflammatory drugs and the initiation of anti-platelet therapy with acetylsalicylic acid, as well as a cycle of <span class="elsevierStyleItalic">P. ovale</span> eradication therapy with primaquine after obtaining a negative result in the screening test for a G6PD deficiency.</p><p id="par0040" class="elsevierStylePara elsevierViewall">We would like to make several comments that we believe to be of interest in relation to this clinical case:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">-</span><p id="par0045" class="elsevierStylePara elsevierViewall">Firstly, we would like to highlight the fact that infarctions secondary to episodes of malaria, especially those caused by <span class="elsevierStyleItalic">P. ovale</span>, are very rare, and to review the multifactorial physiopathological mechanism by which this infection can cause myocardial damage. Previous studies have reported that the adhesion of parasitized and deformed red blood cells to the capillary endothelium may cause a mechanical microvascular obstruction, which is consistent with the findings of our patient's heart MRI. Tissue hypooxygenation secondary to lactic acidosis and the toxic effects caused by the excessive production of pro-inflammatory cytokines by the parasites may also compromise the microcirculation and result in myocardial ischemia.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1–5</span></a></p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">-</span><p id="par0050" class="elsevierStylePara elsevierViewall">Secondly, we wish to highlight the key role of the heart MRI, which helped us redirect our initial diagnosis by revealing late transmural enhancement suggestive of an ischemic etiology and consequently ruled out our initial presumptive diagnosis of myopericarditis.</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">-</span><p id="par0055" class="elsevierStylePara elsevierViewall">Finally, we must emphasize the importance of the serial ECGs, considering that, although their findings were initially clearly suggestive of pericarditis due to the diffuse, concave elevation of the ST segment without a mirrored drop, the readings subsequently evolved into a “more ischemic” appearance with negativization of the T wave and no prior resolution of the ST-segment elevation.</p></li></ul></p><p id="par0060" class="elsevierStylePara elsevierViewall">Hence, this clinical case highlights the importance of considering the diagnosis of AMI in malaria patients presenting with clinical and electrocardiographic features suggestive of myocardial ischemia.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Martín Polo L, Crespillo-Andújar C, Rey Blas JR. Infarto agudo de miocardio secundario a infección por <span class="elsevierStyleItalic">Plasmodium ovale</span>. Med Clin (Barc). 2020;154:325–326.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cardiac involvement in malaria: an overlooked important complication" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S.K. Mishra" 1 => "P.K. Behera" 2 => "S. Satpathi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Vector Borne Dis" "fecha" => "2013" "volumen" => "50" "paginaInicial" => "232" "paginaFinal" => "235" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24220085" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cardiovascular involvement in severe vivax and <span class="elsevierStyleItalic">Falciparum malaria</span>" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "K.C. Nayak" 1 => "S.L. Meena" 2 => "B.K. Gupta" 3 => "S. Kumar" 4 => "V. Pareek" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Vector Borne Dis" "fecha" => "2013" "volumen" => "50" "paginaInicial" => "285" "paginaFinal" => "291" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24499851" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute myocardial infarction in a hospital cohort of malaria" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "K. Jain" 1 => "M. Chakrapani" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4103/0974-777X.59258" "Revista" => array:6 [ "tituloSerie" => "J Glob Infect Dis" "fecha" => "2010" "volumen" => "2" "paginaInicial" => "72" "paginaFinal" => "73" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20300425" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute pericarditis associated with <span class="elsevierStyleItalic">Plasmodium ovale</span> malaria" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "T. Coton" 1 => "P. Debourdeau" 2 => "P. Schoenlaub" 3 => "F. Grassin" 4 => "J. Maslin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Trop (Mars)" "fecha" => "2011" "volumen" => "71" "paginaInicial" => "79" "paginaFinal" => "80" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The microcirculation in severe malaria" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S.J. Rogerson" 1 => "G.E. Grau" 2 => "N.H. Hunt" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1080/10739680490503311" "Revista" => array:6 [ "tituloSerie" => "Microcirculation" "fecha" => "2004" "volumen" => "11" "paginaInicial" => "559" "paginaFinal" => "576" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15513866" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000015400000008/v1_202004190641/S2387020620301017/v1_202004190641/en/main.assets" "Apartado" => array:4 [ "identificador" => "43309" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000015400000008/v1_202004190641/S2387020620301017/v1_202004190641/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020620301017?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2023 March | 2 | 1 | 3 |
