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

Seasonal variation in admission for heart failure, hypertension and stroke in Uyo, south-eastern Nigeria

Background:Seasonal variation in hospitalization for cardiovascular disease has been described in thetemperate regions of the world as well as in Northern Nigeria. Increase admission rates during the coldseasons have been reported in these areas. No studies have been done in Southern Nigeria. This studyis thus aimed at describing the seasonal variation in admissions for heart failure, uncontrolledhypertension and hypertension related-stroke in Southern Nigeria.Methods:Hospital records of patients admitted to the medical wards of the University of Uyo Hospital(UUTH) with heart failure of all causes, uncontrolled hypertension and hypertension­related stroke(Cerebrovascular accident) between January 1998 and December 2001 were used. Epi-Info 2002software was used to analyze data.Results:Of the 3500 patients admitted during the study period 542 (15.3%) were on account of heartfailure, uncontrolled hypertension and hypertension related cerebrovascular accident (CVA). The meanage of patients was 52±12.8 years. The average monthly admission was eleven (11). More admissionswere recorded in the rainy (cold) season than in the dry (hot) season. The observed difference washowever statistically significant only for heart failure and uncontrolled hypertension (P<.05).Conclusion:Admissions for heart failure and uncontrolled hypertension are therefore more during thewet (cold) season in southern Nigeria. This may be attributed to the high default rate to follow up visitin this season when agriculturalactivity is intense and less attention given to medical care. This leads topoor compliance to medications and clinical deterioration. The already bad road network both in ruraland urban centers also become worse at this time making access to medical care difficult. Facilities andmeasures should thus be put in place to provide adequate medical care for these patients during thatperiod of the yea