Acute pneumonia and the cardiovascular system

• Published in: The Lancet (British edition) Vol. 381; no. 9865; pp. 496 - 505
• Main Authors: Corrales-Medina, Vicente F, Dr, Musher, Daniel M, Prof, Shachkina, Svetlana, MD, Chirinos, Julio A, MD
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 09-02-2013; Elsevier; Elsevier Limited
• Subjects: Acute Disease; Adult; adults; Age Distribution; Aged; Aged, 80 and over; Biological and medical sciences; Cardiovascular disease; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - therapy; Cardiovascular System; Cause of Death; Community-Acquired Infections - diagnosis; Community-Acquired Infections - epidemiology; Community-Acquired Infections - therapy; Comorbidity; drugs; Female; General aspects; Health risks; Heart attacks; Hospital Mortality - trends; Humans; Incidence; Internal Medicine; lungs; Male; Medical sciences; Middle Aged; Mortality; Older people; patients; Pneumonia; Pneumonia - diagnosis; Pneumonia - epidemiology; Pneumonia - therapy; Prognosis; risk; Risk Assessment; Severity of Illness Index; Sex Distribution; Survival Analysis; Medicine; Lung disease; Pneumonia; Circulatory system; Respiratory disease; Acute
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(12)61266-5

Although traditionally regarded as a disease confined to the lungs, acute pneumonia has important effects on the cardiovascular system at all severities of infection. Pneumonia tends to affect individuals who are also at high cardiovascular risk. Results of recent studies show that about a quarter of adults admitted to hospital with pneumonia develop a major acute cardiac complication during their hospital stay, which is associated with a 60% increase in short-term mortality. These findings suggest that outcomes of patients with pneumonia can be improved by prevention of the development and progression of associated cardiac complications. Before this hypothesis can be tested, however, an adequate mechanistic understanding of the cardiovascular changes that occur during pneumonia, and their role in the trigger of various cardiac complications, is needed. In this Review, we summarise knowledge about the burden of cardiac complications in adults with acute pneumonia, the cardiovascular response to this infection, the potential effects of commonly used cardiovascular and anti-infective drugs on these associations, and possible directions for future research.