Intra-Cardiac Masses in Adults: A Review of Echocardiogram Records at Two Echocardiographic Laboratories in Enugu; South-East Nigeria

Background: Transthoracic echocardiography (TTE) is an excellent initial diagnostic technique used to evaluate and diagnose cardiac masses; even though transoesophageal echocardiography (TEE) provides superior image resolution and better visualization of cardiac masses; especially in patients with suboptimal transthoracic echocardiographic studies. TTE is the clinical procedure of choice for identification of left ventricular thrombi. TTE has greater than 90 sensitivity and greater than 85 specificity for detection of left ventricular thrombi and is probably superior to the sensitivity and specificity of TEE; especially for apical thrombi.Aims: The study aimed to identify the common types of cardiac masses and their commonest locations in the heart.Materials and Methods: We did a retrospective review of our echocardiogram reports from May 2003 to July 2012 to identify the frequency of intra-cardiac masses in adults; as well as the gender distribution and commonest location of these masses.Results: There were 2;814 echo examinations in adults over this period; comprising 1;661 males (59.1) and 1;153 females (40.9). Intra-cardiac masses were found in 20 of these patients representing 0.7 of the study population. Thrombi were the commonest masses noted in our study; and there were more masses in the atria than in the ventricles. The left heart chambers also had more masses than the right heart chambers. There was no sex difference in the frequency of cardiac masses.Conclusion: Intra-cardiac masses are rare; and transthoracic echocardiography is still valuable in the diagnosis and initial characterization of cardiac masses

Echocardiographic diagnosis of heart disease in Uganda

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