Congestive heart failure triggered by Plasmodium falciparum malaria in a patient with rheumatic heart disease: A case report

Mendiratta P, Kate S, Yadav P, Sahai SK, Hota RN

Pdf Page Numbers :- 83-86

Pushkar Mendiratta^1,*, Shreyas Kate², Priyank Yadav³, Sharad Kumar Sahai⁴ and Rabi Narayan Hota⁵

¹Department of Radiology, Indian Field Hospital Level II, Malakal, South Sudan

²Department of Anaesthesiology, Indian Field Hospital Level II, Malakal, South Sudan

³Department of Internal Medicine, Indian Field Hospital Level II, Malakal, South Sudan

⁴Department of Surgery, Indian Field Hospital Level II, Malakal, South Sudan 5Department of Anaesthesiology, Indian Field Hospital Level II, Malakal, South Sudan

*Corresponding Author: Dr. Pushkar Mendiratta, Department of Radiology, Indian Field Hospital Level II, Malakal, South Sudan. Email: pushkar_indian@yahoo.co.in

Received 20 January 2026; Revised 27 February 2026; Accepted 11 March 2026; Published 20 March 2026

Citation: Mendiratta P, Kate S, Yadav P, Sahai SK, Hota RN. Congestive heart failure triggered by Plasmodium falciparum malaria in a patient with rheumatic heart disease: A case report. J Med Sci Res. 2026; 14(2):83-86. DOI: http://dx.doi.org/10.17727/JMSR.2026/14-16

Copyright: © 2026 Mendiratta P et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Cardiovascular complications of Plasmodium falciparum malaria are uncommon and may be difficult to distinguish from pre-existing cardiac disease or treatment-related adverse effects. We report a case of acute cardiac decompensation in a patient with rheumatic heart disease (RHD) during falciparum malaria. A 46-year-old woman with a history of RHD and previous balloon mitral valvotomy presented with a 5-day history of fever, chills, rigors, body ache, and headache. Malaria rapid diagnostic testing and peripheral blood smear confirmed P. falciparum infection. Approximately 16 hours after admission, she developed acute orthopnoea, cough with pink frothy sputum, chest pain, palpitations, syncope, hypoxaemia, tachycardia, and hypotension. Echocardiography demonstrated severe mitral stenosis, severe tricuspid regurgitation, severe pulmonary arterial hypertension, biatrial enlargement, and preserved left ventricular ejection fraction. Cardiac enzymes and N-terminal pro-B-type natriuretic peptide were within normal limits. She was treated with antimalarial therapy, inotropic and supportive measures, diuretics, pulmonary vasodilator therapy, and anticoagulation. Her clinical condition improved within 12 hours, and vital parameters normalized within 36 hours. She was discharged after 7 days and referred to a higher centre for definitive valvular intervention. This case highlights the potential for P. falciparum malaria to precipitate acute cardiac decompensation in patients with underlying severe valvular heart disease and emphasizes the importance of early cardiovascular assessment in patients with severe malaria.

Keywords: Malaria; Plasmodium falciparum; Heart failure; Rheumatic heart disease; Mitral stenosis; Tricuspid regurgitation; Pulmonary hypertension; Echocardiography