Echocardiographic diagnosis of heart disease in Uganda

ABSTRACT

Five hundred consecutive cardiological patients were reviwed and evaluated by echocardiography in Mulago Hospital as a referral service. All diagnostic problems in cardiology in the hospital and to a certain degree from other isntitutions were reviewed. The commonest diagnosis was endomyocardial fibrosis (EMF) 19.8 ; followed by congenital heart disease (CHD) 15 and rheumatic heart disease (RHD) 11. The anatomical distribution of fibrotic lesions in EMF (left; right or biventriculat) correlated with that found in previous autopsy series from Mulago Hospital thus demonstrating the accuracy of echocardiography. We were able to quantify the contribution of echocardiography to a correct diagnosis which varied between 13in RHD to 90in mitral valve prolapse (MVP). Echocardiography was able to confirm the clinical diagnosis of subacute bacterial endocarditis (SBE in 69of cases. The obtained data suggests that EMF may be the most common heart disease in Uganda contrary to the pattern of heart disease outlined in earlier works. The favourable cost/benefit ratio of echacardiography (i.e. its easy availability and maintenance); as well as the absence of consumable materials in comparison to other cardiac diagnostic tools such as catheterization; chest X-ray and FCG is emphasized; together with the multipurpose use of the machine