Heart failure in Ethiopian children: mirroring the unmet cardiac services

BACKGROUND: HeartFailure (HF) is a progressive clinical and pathophysiological syndrome caused by cardiovascular and noncardiovascular abnormalities. Childhood HF has not been well studied in Sub-Sharan Africa, particularly in Ethiopia. Hence, this study aimed at describing the pattern and outcome of pediatrics HF at a referral-teaching hospital. METHODS: Medical records of 216 HFchildren aged 2months to 14 years, and admitted between January 2014 and January 2016 were reviewed. Clinical information was collected, analyzed and presented in tables and pie charts. RESULTS: A total of 2000 children were admitted to Hawassa University Hospital during the study period. HF accounted for 10.8% (216) of pediatrics admissions, 51.9% males. The median age of the study subjects was 6years. Functionally, NYHA/Ross class III and IV consisted 65(30.1%) and 139(64.4%) of HF. Structural heart diseasewas the commonest cause of HF, 144(66.7%): Rheumatic heart disease (RHD),75(52%), and congenital heart disease (CHD),64(44.5%). Anemia and renal cases contributed to 50(23.1) and 12(5.6%) of HF.CHD was predominantly documented in <5years. Pneumonia 66(42.9%), and infective endocarditis 29(18.8%) were the common precipitating/comorbid conditions with HF.Thecase fatality rate of HF was 13.9 %( 30). CONCLUSION: In this study, HF accounted for a tenth of pediatrics admissions. Structural heart disease was the commonest cause of heart failure. CHD and RHD affected predominantly children of <5years of age and >5 years of age. Echocardiographic screening of HF cases for structural heart disease and optimal care for patients with underlying structural heart disease are recommended

Electrocardiographic Abnormalities in Patients with Heart Failure : Cardiovascular Topics

Background : The morbidity and mortality from heart failure (HF) differ between patients with reduced ( 50) and with preserved ( 50) left ventricular ejection fraction (LVEF) on account of many factors; including abnormalities detected in the electrocardiogram (ECG). The aim of this study was to determine and compare the ECG abnormalities between HF patients with reduced and with preserved LVEF. Methods : The study was cross-sectional in design and carried out in Aminu Kano teaching hospital and Murtala Mohammed specialist hospital; Kano; Nigeria; from April 2005 to June 2006. We studied the resting electrocardiograms of all HF patients aged 15 years and older who were referred to the two centres for echocardiography. Results: A total of 113 patients were studied and 98.2of them had abnormal ECGs. Forty-two patients (37.2) had preserved LVEF while the remaining 71 (62.8) had reduced LVEF. Left ventricular hypertrophy ( LVH) was the commonest ECG abnormality; found among 55 patients (77.5) with reduced LVEF; and 21 patients (50) with preserved LVEF (p = 0.0026). The commonest arrhythmia was atrial fibrillation; found among 10 patients (14.1) with reduced LVEF and eight patients (19.1) with preserved LVEF (p = 0.486). Prolonged corrected QT interval was found among 30 (71.4) and 56 patients (78.9) with preserved and reduced LVEF; respectively (p = 0.370). Conclusion: Most of the patients with heart failure studied in Kano; Nigeria had abnormal electrocardiograms; and the most common abnormality was LVH

Attitude therapeutique devant l'insuffisance cardiaque congestive aux Cliniques Universitaires de Kinshasa

Les auteurs analysent l'attitude therapeutique des medecins au Departement de Medecine Interne devant l'insuffisance cardiaque congestive. 26 patients des 30 patients insuffisants cardiaques admis ont ete retenus dans cette etude retrospective allant de janvier a decembre 1989. L'analyse du type de traitement prescrit; de la mortalite au cours de l'hospitalisation et de l'impact financier de chaque association medicamenteuse montre une tendance elevee de prescrire les vasodilateurs veineux qui levent plus tot l'insuffisance cardiaque congestive; un impact financier moins important avec ces vasodilateurs; une lourde mortalite en presence du SIDA. Les femmes (65;4 pour cent) sont plus nombreuses que les hommes (34;6 pour cent). La cardiomyopathie idiopathique est l'etiologie couramment rencontree avec 54;2 pour cent