Clinical and Echocardiographic Study of Hypertrophic Cardiomyopathy in Tanzania

There are few published reports on Hypertrophic Cardiomyopathy (HCM) in Africans. Due to lack of echocardiography machines in most hospital centers; clinical identification of HCM remains confined to those patients with a loud heart murmur associated with the outflow gradient. Between June 1998 and October 2002; 134 patients were studied at Hindu Mandal Hospital; 67.9were male and 32.1were female. Their mean age was 54.8 + 14.2 years. The presenting symptoms were Dyspnoea 62.7; Chest pain 55.9; Palpitations 50.7(Pre-syncope 21.6; Syncope 8.9) Due to the diverse clinical features; only 8(5.9) patients had a correct diagnosis of Hypertrophic Cardiomyopathy in their echocardiography request forms. Others were diagnosed as Ischaemic heart disease 31.8; Dilated Cardiomyopathy 29.9; Mitrol valve prolapse 11.2and Arrhythmias 6.7. Using Echocardiography; the pattern of LVH among these patients was found to be: Asymmetrical septal hypertrophy in 50.7and apical hypertrophy in 3.0. The important role of echocardiography in diagnosis is stressed with a plea for the increasing availability of this non-invasive technique for early and accurate diagnosis of Hypertrophic Cardiomyopathy

Clinical aspects and management of hypertensive crisis (current state of the art)

Despite the large number of patients with chronic hypertension; hypertensive crisis constitutes a relatively rare medical emergency. However; a marked and sudden elevation in blood pressure may represent an immediate threat to life by causing cardiovascular and nephrovascular complications. Proper management of the hypertensive crisis is essential to avoid further catastrophic injury to the end organs as a delay in initiating the appropriate effective therapy or of overzealous therapy leading to a too-rapid reduction in blood pressure

Chronic chloroquine use- A cause of complete heart block

There have been occasional reports of complete heart block in chronic use of chloroquine; in most of these cases this has followed chronic abuse. Self medication is common in Tanzania; where malaria is endemic and chloroquine is easily available in ordinary shops and pharmacies. This is a report of a patient who developed complete heart block; and poor vision following chronic chloroquine abuse

Accelerated and malignant hypertension at Muhimbili Medical Centre

During the period between February 1986 and February 1987; 29 patients with accerlated and malignant hypertension were admitted to the medical wards of Muhimbili Medical Centre; Dar es Salaam. The mean age of the patients was 40 years (range 19-61 years). 15 (51.7 percent) patients were in cardiac failure and 13 (44.8 percent) patients had renal failure. 11 (37.9 percent) patients died. The causes of death were: neurological complications 5; renal failure 4; and cardiac failure 2. Because the features of accerlated and malignant hypertension are diverse; a high index of suspicion and thorough examination is needed for its diagnosis. Deaths were due to the complications which can be prevented by proper management; follow-up and education of patients with begign hypertension