Publication: Electrocardiographic monitoring in severe falciparum malaria
Issued Date
1996-01-01
Resource Type
ISSN
00359203
Other identifier(s)
2-s2.0-15844422799
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Transactions of the Royal Society of Tropical Medicine and Hygiene. Vol.90, No.3 (1996), 266-269
Suggested Citation
Delia B. Bethell, Pham Tung Phuong, Cao Xuan Thanh Phuong, François Nosten, Deborah Waller, Timothy M.E. Davis, Nicholas P.J. Day, Jane Crawley, David Brewster, Sasithon Pukrittayakamee, Nicholas J. White Electrocardiographic monitoring in severe falciparum malaria. Transactions of the Royal Society of Tropical Medicine and Hygiene. Vol.90, No.3 (1996), 266-269. doi:10.1016/S0035-9203(96)90241-2 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/17648
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Title
Electrocardiographic monitoring in severe falciparum malaria
Other Contributor(s)
Cho Quan Hospital
John Radcliffe Hospital
Dong Nai Paediatric Centre
Shoklo Malaria Research Unit
Royal Victoria Teaching Hospital Gambia
Medical Research Council Laboratories Gambia
Mahidol University
University of Western Australia
Wellcome Trust Research Laboratories Nairobi
Royal Darwin Hospital
John Radcliffe Hospital
Dong Nai Paediatric Centre
Shoklo Malaria Research Unit
Royal Victoria Teaching Hospital Gambia
Medical Research Council Laboratories Gambia
Mahidol University
University of Western Australia
Wellcome Trust Research Laboratories Nairobi
Royal Darwin Hospital
Abstract
Electrocardiographic monitoring over 24 h was performed with 53 patients with severe Plasmodium falciparum malaria (11 adults and 42 children) to assess the frequency of unrecognized cardiac arrhythmias. Nine patients (17%) died, 5 during the monitoring period and 4 afterwards. Pauses lasting 2-3 s were observed in 3 children, a single coupler in one, and a further child experienced frequent supraventricular ectopic beats which had not been detected clinically. In none of the patients who died could death be attributed to cardiac arrhythmia. Furthermore, no abnormality was detected which could have resulted from the often large doses of quinine, chloroquine or the artemisinin derivatives used for treatment. These results suggest that the heart is remarkably resilient even in the face of heavy parasite sequestration and other vital organ dysfunction, and that deaths from cardiac arrhythmias in severe malaria are rare. The need for routine cardiac monitoring of patients with severe and complicated P. falciparum malaria is questionable.