Q. Can a recent malarial infection create an impact on the heart health of a 71-year-old male?

Answered by
Dr. Mandurke Vivek Maroti
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Sep 15, 2022 and last reviewed on: Feb 09, 2023

Hi doctor,

My father is 71 years old and recently got malaria (vivax), due to which his platelet counts dipped to 44000 mcL. In addition to blood tests, the doctor did an ECG as a routine procedure and found RBBB. The doctors said RBBB was not there in his ECG 10 years ago. During malarial shivers, his blood also seemed to have shown high levels of a cardiac enzyme, probably CPT. Now he is cured of malaria and is doing fine (platelets are 3.5 lakhs now). Today, after two weeks, again, his ECG showed RBBB. My father never had any pain in the chest and is leading an active lifestyle. For RBBB, the doctors have prescribed one tablet of Clopidogrel 75 mg and one tablet of Atorvastatin 10 mg daily for the next six months. And they have asked him to come after six months for a review. In addition, my father has low blood pressure and prostatitis. However, I have a few questions,

1. Is RBBB a condition that can lead to heart-related emergencies? What is RBBB exactly? Is it an artery clog? Or a fat deposition?

2. Can Clopidogrel and Atorvastatin cure RBBB (without the need for surgery)?

3. I read on the internet that Clopidogrel is usually prescribed for a maximum of 12 months. What happens if it is used beyond 12 months? Does the patient become addicted? Or is the platelet's function damaged?

4. I have read on the internet that many healthy people also have RBBB and live with it without any problems or symptoms. Is it true?

5. What further tests would you suggest, like cholesterol, CPT, troponin enzyme, etc., or any RBBB-specific tests?

6. Is Atorvastatin also given a maximum to a period of one year?

I have also attached the ECG picture for your reference.

Kindly answer my questions.



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The right and left bundles are conducting structures of an electrical signal. But with aging and due to other reasons, it does not transmit an electrical signal. So it leads to the right bundle branch block, so the right side conduction is taken over by the left. And this is a slightly delayed condition but nothing to worry about. However, I suggest you to do an echocardiogram. If the results are normal, you need not worry about RBBB (Right bundle branch block). As for Clopidogrel (antiplatelet agent) and Atorvastatin (statins), if tolerating well, it can be continued. However, its benefits are doubtful, but if there are no side effects, then there is no harm. However, in the absence of heart disease, it is not indicated. But many physicians give these medications considering old age as they may have the possibility of getting mild heart blocks. So we call it primary prophylaxis.

I hope this has helped you.

Take care.

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