Abstract:
cardiovascular abnormalities in
children and adolescents with sickle cell anaemia attending sickle cell clinic at Muhimbili
National Hospital.
Design: Cross -sectional hospital based descriptive study
Methodology: Children aged six months to seventeen years, attending sickle cell clinic
were randomly selected. History was taken, physical examination was done and
haemoglobin level was measured. Then chest radiography, electrocardiography and
echocardiography were done.
Outcome: Magnitude and pattern of cardiovascular disorders among patients with sickle
cell anaemia.
Results: Ninety-nine patients met the criteria for inclusion and were subject for final
analys is. Males were 54 and females were 45, male to female ratio was 1: 1.7. Mean
haemoglobin level was 7.2g/dl (range 4.9-10)
The overall prevalence of cardiac abnormalities in this study was 28 %. Prevalence
according to individual diagnostic parameters was ECG; 50.5%, CXR; 69.7%, cardiac
signs 76.8% and ECHO; 83.3%.
Vlll
Tachycardia was common in children aged 6 years or below (P=0.005), cardiomegaly,
presence of cardiac murmurs and abnormal ST- T changes were significant in children
above 6 years (p= 0.0009,0.012 and 0.013 respectively).
Patients with haemoglobin of 8g/dl or less frequently had tachycardia (P=O.OOl), cardiac
murmurs (P=O.OOOOl), prominent pulmonary vasculature (P=0.04) and upper lobe blood
redistribution (P=O. 014).
Cardiac chamber dilatation and left ventricular hypertrophy were inversely related to
haemoglobin level. Systolic dysfunction was significantly reduced in 23.3% of patients
with haemoglobin of 8g/dl and below.
Diastolic dysfunction was found in 51 % of patients, this was about four times common in
patients with haemoglo bin of 8g/d I and below.
Conclusions and recommendations:
Cardiomegaly was the most common cardiovascular abnormality found in sickle cell
anemia patients above six years, in particular those with chronic anemia and hemoglobin
:s 8gmld1. These patients need to have their hemoglobin maintained above 8gmldl and
those with hemoglobin below 8gmldl plus cardiovascular signs would need cardiovascular
evaluation.
