Plasmodium Vivax Malaria and Cardiac Complication

Abstract

Plasmodium vivax (P. vivax) is known as a benign pattern of malaria. In recent years, Plasmodium vivax can also cause severe malaria infection that contributes to various manifestations in human organs. Cardiac complications associated with P. vivax malaria are rarely seen, but have recently been reported. This review aimed to identify the cardiac complication related to P. vivax malaria. Articles about cardiovascular manifestation in P. vivax malaria were collected from databases, including Google Scholar and PubMed. Relevant articles about P. vivax malaria and other severe malaria were included. Cardiac complication has occurred in malaria due to single P. vivax infection as seen in P. falciparum infection. There are only limited articles of cardiac involvement in P. vivax malaria and most of them are case reports. Myocarditis is the most common cardiovascular complication associated with severe P. vivax malaria. The key symptom that indicates a vivax malaria patient with cardiac complication is chest pain or chest discomfort especially in the substernal area. Some manifestations of cardiac related to P. vivax malaria are ventricle dilatation, decrease left ventricular ejection, hypokinesis of myocardium, change in cardiac enzyme, and ECG alterations. These clinical symptoms are emerging in young children and adult patients. Reported cases are the most typical in vivax endemic regions. The subclinical cardiovascular alteration also presents in patients with non-severe P. vivax malaria. Our review identifies a potential link between P. vivax single-infection and cardiovascular manifestations. It is essential to consider the possibility of cardiac complication in P. vivax malaria with a worsening condition. Further and more extensive studies of cardiac involvement in P. vivax malaria are required, especially in endemic areas.