Bacterial pneumonia patients at increased risk of major heart problems
A new study suggests patients hospitalized with pneumonia may be at serious risk of new or worsening heart problems. The study is published in the July 15 issue of Clinical Infectious Diseases, currently available online.
Researchers led by Daniel Musher, MD, studied the records of all 170 patients hospitalized with pneumococcal pneumonia at a Texas Veterans Affairs medical center from 2001 to 2005. They found that 19.4 percent of them had a heart attack or other major heart problem concurrently at the time of admission, and that the presence of the heart condition significantly increased mortality from pneumonia.
In this study, the authors note, when adult patients were hospitalized with a diagnosis of bacterial pneumonia, the concurrence of pneumonia and a new cardiac event was often unrecognized, especially in the first 12-24 hours of hospitalization, which led some patients to go without antibiotics for pneumonia and others to have no cardiac monitoring or anticoagulant therapy.
The authors propose that pneumonia increases the risk of heart problems by increasing the hearts demand for oxygen while simultaneously causing a decrease in the lungs ability to transfer oxygen from the air to the blood. Also, pneumonia raises blood levels of a type of a chemical signal called a cytokine that promotes the formation of blood clots and that decreases the efficiency of the heart.
Physicians who take care of patients with pneumonia or with acute coronary syndromes need to be aware of the possible concurrence of the two diseases in an individual patient, said Dr. Musher.
Fast Facts
Nearly 20 percent of patients admitted with pneumococcal pneumonia at a Texas Veterans Affairs medical center had a heart attack or other major heart problem concurrently at the time of admission, and the heart condition significantly increased mortality from pneumonia.
When patients were diagnosed with pneumonia, the heart problem frequently went unrecognized.
Physicians should be aware of the possibility that a patient has both conditions.
Conclusions: Patients with pneumococcal pneumonia are at substantial risk for a concurrent acute cardiac event, such as MI, serious arrhythmia, or new or worsening CHF. This concurrence significantly increases mortality due to pneumonia. Admitting physicians tend to seek a unifying diagnosis, but the frequent coexistence of pneumonia and cardiac events indicates the importance of considering multiple diagnoses.
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