Clinical Evaluation of Cardiac Involvement in Pneumonia

Pneumonia is a major cause of morbidity and mortality throughout the world in the earlier decades before the advent of antimicrobials. After the advent of antibiotics, a spectacular improvement in the control of infection was expected, but it still exists and quite prevalent. In India, because of low socioeconomic status, overcrowding and increasing HIV infection pneumonia is still an important cause of morbidity and mortality. As pneumonia has predilection to elderly individual, they are more prone for developing secondary cardiac complications, such as pericarditis which carry high mortality rate if left untreated. AIMS: To know the frequency of cardiac involvement and the type of cardiac involvement in pneumonias. MATERIAL AND METHODS: This is a Non Randomized Descriptive Study. Patients both female and males above 12 years with history of fever, cough, with or without pleuritic chest pain with radiological appearance suggesting pneumonic consolidation are included in the study. Patients who fulfill the inclusion criteria are included in the study. Detailed history regarding complaints, antibiotic treatment received prior to admission to our hospital followed by detail general physical examination, respiratory system examination, cardiovascular system examination and gastrointestinal system examination. Then patients were investigated with routine blood examinations; renal parameters; sputum examination by Gram's stain, culture and sensitivity, KOH preparation, ZN staining; chest x-ray ; Blood C/S; ECG; 2D echocardiogram. Clinical and laboratory criteria are used for making the diagnosis of pericarditis, myocarditis and endocarditis in the absence of evidence of an acute myocardial infarction or history of previous cardiac disease. RESULTS: Out of 40 Patients, 25 were males and 15 were females. In 40 patients only 2 developed cardiac complication which accounts for 5% Of the 2 cardiac complications, both were pericarditis. Of the 2 cardiac complication which we encountered in our study, both of the patients had not received antibiotic treatment prior to admission. CONCLUSION: Cardiac involvement secondary to pneumonia are still present, but the incidence compared to the pre antibiotic era it is very less. It's the Untreated pneumonias which secondarily involve cardia. Of the cardiac complications, pericarditis is common whereas myocarditis and endocarditis are uncommon.