Kaagaard MD, Matos LO, Holm AE, et al. - The frequency of ECG alterations, determined by ECG and Holter monitoring, and pericardial effusion were investigated in patients with malaria infection.

• In this prospective observational study of adult patients with uncomplicated malaria, 98 cases were included (55% men; mean age 40 years; median parasite density 1,774/µl); 75 with Plasmodium vivax, 22 with Plasmodium falciparum, and 1 with mixed infection.

• At baseline, PR-segment depression was evident in 17% (n = 17), PR-segment elevation was noted in 12% (n = 12), Spodick's sign was recorded in 3% (n = 2), and pericardial effusion was prevalent in 9% (n = 9).

• For identification of pericardial effusion at baseline, ECG alterations had sensitivities of 22% to 89% and specificities of 88% to 100%.

• The best accuracy was recorded for PR-segment depression (sensitivity 89%, specificity 90%).

• Findings overall support the utility of ECG alterations in detecting pericardial effusion in malaria and indicate that the abnormalities reduce after completion of antimalarial treatment.