Cardiac dysfunction in active pulmonary tuberculosis: Mysterious facts of TB’s pandora

<b>Introduction</b>: Cardiac dysfunction in pulmonary tuberculosis is relatively more common and underestimated due to lack of suspicion. We have studied prevalence cardiac with special emphasis on echocardiography, serum cortisol its correlation cases unstable cardiorespiratory parameters.<br /> <b>Methods:</b> Prospective, observational, complete workup, one year follow up study conducted during January 2016 December 2020 included 800 active specified inclusion criteria disproportionate tachycardia, tachypnea or without hypoxia shock. Cases known risk factor for disease taking medicines, pericardial effusion were excluded from study. All undergone protocolized analysis such as chest radiograph, pulse oximetry, ECG, sputum examination, enzymes (CPK-MB, NT-Pro-BNP, troponins), cortisol, echocardiography at entry point, two six months treatment anti-tuberculosis medicines per NTEP. Statistical was carried out by Chi-square test.<br <b>Observations analysis: </b>In a cases, 56.00% (448/800) males, 44.00% (352/800) females. BMI<18 41.62% (333/800) BMI>18 58.37% (467/800). Radiological patterns unilateral 33.62% (269/800) & bilateral 66.37% (531/800). Hemoglobin less than 10 gm% documented 85.12% (681/800) above 14.87% (119/800) cases. Serum albumin 3.5 observed 48.12% (385/800) 51.12% (415/800) respectively. Hypoxia 26.12% (209/800) normal oxygen saturation 73.87% (591/800) abnormal 61.37% (491/800) 38.62% (309/800) Sputum examination AFB 30.00% (240/800) gene Xpert MTB/RIF 51.37% (411/800) Bronchoscopy guided techniques used 149 BAL smear 44.96% (67/149) 97.31% (145/149) MGIT culture four (positive 100% subjected culture). global hypokinesia predominant 82.21% (171/208) followed left heart systolic 16.34% (34/208) diastolic 75% (156/208) Right dilated right atrium ventricle 52.88% (110/208) hypertension 40.38% (84/208) Covariates age, gender, hemoglobin, BMI, albumin, radiological involvement has significant association dysfunction. (p<0.00001) Response antituberculosis steroids improved 77.40% (161/208) persistent 13.46% (28/2028) progressive 9.13% (19/208) Final outcome Pulmonary level (p<0.00086).<br <b>Conclusion:</b> needs prompt workup presence tachypnea, tachycardia Echocardiography basic tool evaluate these hypokinesis most abnormality. abnormality fair number very well correlated ventricular abnormalities. Steroids backup mainstay protocol management reversible majority proportionate shown improvement