Pattern of cardiac diseases at muhimbili national hospital dar es salaam, 2007.

Abstract

Background Cardiac diseases are on a global rise, emerging as diseases of public health importance in Sub Saharan Africa today. The majority of the conditions are attributable to changing life styles in rural and rapid trends towards urbanization and globalization. The diseases include Coronary heart diseases, Cardiomyopathies, Rheumatic valvular heart diseases, pericardial diseases, congenital heart diseases and hypertensive heart diseases. The patterns of these diseases have been changing over time. The current pattern of these conditions is not known and need to be described and stand as a starting point for disease intervention and priority setting in Tanzania, by the Ministry Of Health and Social Welfare and other Organizations. Objective: To describe the pattern of cardiac diseases among patients Aged 7 years or older attending cardiac clinics and medical wards at Muhimbili National Hospital, Dar es Salaam Tanzania 2007. Settings: Medical wards and cardiac clinic at Muhimbili National Hospital. Study subjects: Patients aged 7 years or older attending cardiac clinic and those with features of heart diseases admitted to medical wards. Methods: A descriptive cross sectional study was done from 1 st July to 31 st November 2007. During the five months period, a total of 250 cardiac patients attending at cardiac clinic and those admitted in medical wards at Muhimbili National hospital were evaluated. Each patient had history and demographic information taken, physical examination, chest roentgenography, Electrocardiography and Echocardiography done. Main outcome measure: Cardiac diagnosis Results: Of the 250 patients evaluated, 76 (48.7%) of cases were females. The median age of the study subjects was 32.5(±21.8) years. 66% were below 41 years of age. Rheumatic valvular heart disease was the predominant diagnosis detected in 115(46%) patients. There was female dominance with 76 (66.1%) being affected. Mitral valve stenosis was seen predominantly in females. Other diagnoses were: Hypertensive heart disease 53(21.3%), cardiomyopathies 28 (11.2%), Mitral valve prolapse 26(10.4%), pericardial disease15 (6.0%) and Congenital heart diseases 11 (4.4%). Ischaemic heart disease 3 (1.2%) were the least diagnosed. Majority of patients attended were at advanced stages of heart failure, had low level of education and social economic status. Conclusion: Rheumatic valvular heart diseases still ranks high among the preventable cardiac diseases, affecting a younger population mainly females than males. Many arrive late and are diagnosed in advanced stages of the disease at a referral hospital. Appropriate clinical and early Echocardiographic assessment should be made available even at Regional hospitals for early diagnosis. The magnitude of ischaemic heart diseases is still low in this population.