From the Guidelines
This 20-year-old female should not donate plasma at this time due to the suspected heart murmur and EKG abnormalities, which require further medical evaluation to ensure her safety. The presence of a short PR interval in isolation, as indicated by the EKG, may not be immediately concerning according to the international recommendations for electrocardiographic interpretation in athletes 1, but the combination of this finding with a suspected heart murmur raises the need for a thorough cardiac assessment. The patient's cardiac status needs to be fully evaluated by a cardiologist, which may include tests such as an echocardiogram, extended cardiac monitoring, and possibly exercise testing, to determine if the EKG findings and heart murmur represent significant cardiac pathology. Plasma donation can impose cardiovascular stress due to fluid shifts and changes in blood volume, potentially triggering arrhythmias in individuals with underlying conduction abnormalities like short PR syndrome. Therefore, prioritizing patient safety, a temporary deferral from plasma donation is warranted until the cardiac evaluation is completed and it is confirmed that these findings do not pose a risk to her health. The recent study on preparing plasma and serum 1 provides guidelines on the preparation and handling of plasma samples but does not directly address the eligibility criteria for plasma donation in individuals with suspected cardiac conditions, making the guidance from 1 more relevant to this clinical decision.
From the Research
Plasma Donation Eligibility
The eligibility of a 20-year-old female to donate plasma, given her potential heart murmur and EKG results showing a borderline rhythm with short PR syndrome, depends on various factors.
- The presence of a short PR interval, as indicated by the EKG results, may be associated with an otherwise normal electrocardiogram or various electrocardiographic abnormalities, as noted in 2.
- The individual may be asymptomatic or experience complex arrhythmias, which can be disabling and rarely cause sudden death.
- The diagnostic accuracy of a cardiac examination in determining the cause of a systolic murmur is limited, especially if more than one lesion is present, as found in 3.
- Echocardiography is essential in evaluating systolic murmurs of unknown cause, as it can help identify underlying heart conditions such as aortic stenosis, mitral regurgitation, or ventricular septal defect.
- The correlation between murmurs by auscultation and severity of heart valve disease by echocardiography is generally poor, as stated in 4.
- The utility of echocardiograms in evaluating heart murmurs is well-established, and they are frequently ordered for cardiovascular indications, as discussed in 5.
Donation Decision
Given the potential risks associated with the donor's condition, it is crucial to assess her eligibility carefully.
- The presence of a short PR interval and potential heart murmur may require further evaluation to determine the underlying cause and assess the risk of donating plasma.
- The decision to allow or deny plasma donation should be based on a comprehensive medical evaluation, including echocardiography and other diagnostic tests, to ensure the donor's safety and the quality of the donated plasma.