Abstract:
INTRODUCTION:Rheumatic heart disease (RHD) continues to cause gross distortions of the heart and the associated complications of heart failure and thromboembolic phenomena in this age of numerous high-efficacy drugs and therapeutic interventions. Due to the lack of contemporary local data, there is no national strategy for the control and eradication of the disease in Uganda. This study aimed to describe the presenting clinical features of newly diagnosed patients with RHD, with particular reference to the frequency of serious complications (atrial fibrillation, systemic embolism, heart failure and pulmonary hypertension) in the study group. METHODS:One hundred and thirty consecutive patients who satisfied the inclusion criteria were recruited over a period of eight months from June 2011 to January 2012 at the Mulago Hospital, Uganda. Data on demographic characteristics, disease severity and presence of complications were collected by means of a standardised questionnaire. RESULTS:Seventy-one per cent of the patients were female with a median age of 33 years. The peak age of the study group was 20 to 39 years, with the commonest presenting symptoms being palpitations, fatigue, chest pain and dyspnoea. The majority of the patients presented with moderate-to-severe valvular disease. Pure mitral regurgitation was the commonest valvular disease (40.2%), followed by mitral regurgitation plus aortic regurgitation (29%). Mitral regurgitation plus aortic regurgitation plus mitral stenosis was found in 11% of patients. There was only one case involving the tricuspid valve. The pulmonary valves were not affected in all patients; 45.9% of patients presented in severe heart failure in NYHA class III/IV, 53.3% had pulmonary hypertension, 13.9% had atrial fibrillation and 8.2% had infective endocarditis. All patients presented with dilated atria (> 49 mm). CONCLUSION:A significant proportion of RHD patients present to hospital with severe disease associated with severe complications of advanced heart failure, pulmonary hypertension, infective endocarditis and atrial fibrillation. There is a need to improve awareness of the disease among the population, and clinical suspicion in primary health workers, so that early referral to specialist management can be done before severe damage to the heart ensues.
journal_name
Cardiovasc J Afrjournal_title
Cardiovascular journal of Africaauthors
Zhang W,Mondo C,Okello E,Musoke C,Kakande B,Nyakoojo W,Kayima J,Freers Jdoi
10.5830/CVJA-2012-076subject
Has Abstractpub_date
2013-03-01 00:00:00pages
28-33issue
2eissn
1995-1892issn
1680-0745journal_volume
24pub_type
杂志文章abstract:OBJECTIVES:Previous studies have suggested that failure of the synthesis of nitric oxide is involved in the pathophysiology of myocardial ischaemia-reperfusion injury. In this study, we investigated the effect of mebudipine, a new dihydropyridine calcium channel blocker, on cardiac function and activity of the myocardi...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:10.5830/CVJA-2010-078
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVE:Cardiac resynchronisation therapy has been shown to be an effective treatment to improve functional status and prolong survival of patients in advanced chronic heart failure. This study assessed the surgical outcomes of left anterior mini-thoracotomy for the implantation of left ventricular epicardial pacing ...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:10.5830/CVJA-2016-046
更新日期:2017-01-01 00:00:00
abstract::This review discusses the 1987 article by Wyndham, Seftel, Pilcher and Baker on familial hypercholesterolaemia (FH) and myocardial infarction (MI) in young Afrikaners, in terms of the significance at the time of publication, as well as the relevance of their findings versus current observations on hypercholesterolaemi...
journal_title:Cardiovascular journal of Africa
pub_type: 历史文章,杂志文章
doi:
更新日期:2009-01-01 00:00:00
abstract::In developing countries, rheumatoid arthritis (RA) remains a seriously under-prioritised disease, particularly among the underprivileged, often resulting in presentation of patients late in the course of their disease, further complicated by limited therapeutic options and inconsistent follow up. The consequences are ...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章,评审
doi:10.5830/CVJA-2018-018
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Methods of closing patent ductus arteriosus (PDA) have evolved over time. We review this development in our setting. METHODS:This was a retrospective analysis of children who had transcatheter PDA closure at Chris Hani Baragwanath Hospital between 1993 and 2008. RESULTS:Over 15 years, 1 254 PDAs were diagn...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:10.5830/CVJA-2018-028
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Left atrial remodelling (LAR) has been described in Western populations with chronic hypertension and is associated with a higher risk of adverse cardiovascular events. Although hypertension tends to occur earlier and is more severe in sub-Saharan Africa than in more developed nations, LAR and its associated...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:10.5830/CVJA-2019-046
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:The aims of this study were to report on our experience with upper limb ischaemia (ULI), to define the pattern and distribution of disease, describe key demographic features and report on conventional clinical outcomes. METHODS:This was a single-centre, retrospective, descriptive study. All patients (n = 64)...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:10.5830/CVJA-2017-049
更新日期:2018-03-01 00:00:00
abstract::We present the case of a three-month-old infant with a giant right atrial myxoma obstructing the tricuspid valve, who following haemodynamic deterioration and cardiac arrest, was operated upon as an emergency. On echocardiogram, there was a mass attached to the tricuspid annulus, in close proximity to the septal leaf...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:10.5830/CVJA-2010-099
更新日期:2012-02-12 00:00:00
abstract:OBJECTIVES:Little is known about the performance of re-used pacemakers and implantable cardioverter defibrillators (ICDs) in Africa. We sought to compare the risk of infection and the rate of malfunction of re-used pacemakers and ICDs with new devices implanted at Groote Schuur Hospital in Cape Town, South Africa. MET...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:10.5830/CVJA-2015-048
更新日期:2015-07-01 00:00:00
abstract::Cardiovascular disease (CVD) is the frontrunner in the disease spectrum of sub-Saharan Africa, with stroke and ischaemic heart disease ranked seventh and 14th as leading causes of death, respectively, on this sub-continent. Unfortunately, this region is also grappling with many communicable, maternal, neonatal and nut...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章,评审
doi:10.5830/CVJA-2016-082
更新日期:2017-07-01 00:00:00
abstract::We researched hypertrophic cardiomyopathy (HCM) and long QT syndrome (LQTS) as models for studying the pathophysiology of arrhythmias and hypertrophy, and in the process we have had the opportunity to compare local disease profiles with global patterns. We trawled our database entries over the past 20 years to identif...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:
更新日期:2007-09-01 00:00:00
abstract::We present the case of a 57-year-old female who experienced iatrogenic left main-stem (LMS) dissection during elective coronary angiography. The dissection immediately affected the circumflex artery (Cx), causing its total distal occlusion, and the left anterior descending artery (LAD), in which a metal stent, implant...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:10.5830/CVJA-2015-060
更新日期:2015-11-23 00:00:00
abstract:INTRODUCTION:The functional significance of coronary artery collateral (CAC) vasculature in humans has been debated for decades and this has been compounded by the lack of a standard, systematic, objective method of grading and documenting CAC flow in man. CACs serve as alternative conduits for blood in obstructive cor...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:10.5830/CVJA-2016-054
更新日期:2017-03-01 00:00:00
abstract::A 104-year-old male patient was admitted to the emergency department with chest pain. An electrocardiogram showed ST-segment elevation in the anterior leads. He was immediately taken to the catheterisation laboratory for emergency angiography, which showed thrombotic stenosis at the proximal portion of the left anteri...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:10.5830/CVJA-2014-001
更新日期:2014-02-23 00:00:00
abstract:AIM:To investigate the osteogenic differentiation of vascular smooth muscle cells (VSMCs) in mice with chronic kidney disease (CKD) and to evaluate the effects of p53 on the osteogenic differentiation of the VSMCs. METHODS:Experimental models of CKD-associated vascular calcification generated by five-sixth (5/6) nephr...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:10.5830/CVJA-2011-069
更新日期:2012-07-12 00:00:00
abstract:OBJECTIVE:Few data are available on heart failure (HF) in sub-Saharan Africa. We aimed to provide a current picture of HF aetiologies in urban Uganda, access to heart surgery, and outcomes. METHODS:We prospectively collected clinical and echocardiographic data from 272 consecutive patients referred for suspected heart...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:10.5830/CVJA-2014-034
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Recent studies have shown that the Tp-e interval, which on an electrocardiogram (ECG) is the interval between the peak and the end of the T wave, can be used as an index of transmural dispersion of ventricular repolarisation (TDR). Both Tp-e/QT and Tp-e/QTc ratios have also been used in that capacity. Howeve...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:10.5830/CVJA-2018-043
更新日期:2018-11-01 00:00:00
abstract::Surgical repair or replacement of the mitral valve is currently the only recommended therapy for severe primary mitral regurgitation. The chronic elevation of wall stress caused by the resulting volume overload leads to structural remodelling of the muscular, vascular and extracellular matrix components of the myocard...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章,评审
doi:10.5830/CVJA-2017-009
更新日期:2018-01-01 00:00:00
abstract::Left ventricular hypertrophy is a common complication of primary hyperparathyroidism. Numerous disturbances of myocardial physiology have been described as a result of excess parathyroid hormone action. In this brief communication, another phenotype of the hyperparathyroid heart is proposed, the 'pseudo-myocardial inf...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:
更新日期:2009-05-01 00:00:00
abstract::We present images of a chest CT scan of an 89-year-old man, showing an area of localised dissection in the convexity of the aortic arch. The ascending and descending aorta were not involved in the disease. The patient suffered a stroke, with severe neurological impairment. Differential diagnosis was undertaken. ...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:
更新日期:2009-11-01 00:00:00
abstract:OBJECTIVES:Few studies have evaluated young adults in their third and fourth decades with coronary artery disease (CAD). This study evaluated the clinical and angiographic profile of young adults ( < 35 years) with CAD. METHODS:A 10-year (2003-2012) retrospective chart review was performed on patients less than 35 yea...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:10.5830/CVJA-2017-035
更新日期:2018-01-01 00:00:00
abstract::Very late bare-metal stent (BMS) thrombosis is unusual in clinical practice. To the best of our knowledge, the latest that the thrombosis of a BMS has been reported is 14 years after implantation. Here, we describe a case of BMS thrombosis that occurred two decades after stenting. A 68-year-old male patient was admitt...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:10.5830/CVJA-2015-034
更新日期:2015-07-23 00:00:00
abstract:BACKGROUND:Cardiac complications of human immunodeficiency virus (HIV) infection are important causes of morbidity and mortality. We set out to determine the electrocardiographic (ECG) abnormalities in treatment-naïve HIV-positive patients in Enugu, south-east Nigeria. METHODS:This was a cross-sectional study involvin...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:10.5830/CVJA-2017-013
更新日期:2017-09-01 00:00:00
abstract:INTRODUCTION:Associations between ambient temperature and blood pressure have been demonstrated in countries where the temperature varies between the seasons. This phenomenon has been overlooked in blood pressure surveys in sub-Saharan Africa. We assessed the effect of ambient temperature on blood pressure in an adult ...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:
更新日期:2010-01-01 00:00:00
abstract:INTRODUCTION:Pulmonary thromboembolism (PTE) may increase D-dimer and decrease fibrinogen levels. However, in settings such as intensive care units (ICU) and in long-term hospitalised patients, several factors may influence D-dimer and fibrinogen concentrations and make them unreliable indicators for the diagnosis of P...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:10.5830/CVJA-2012-041
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:Guidelines advise early angiography in non-ST elevation myocardial infarction (NSTEMI) to ensure an optimal outcome. Resource limitations in secondary hospitals in the Western Cape dictate a local guideline to treat NSTEMIs medically with out-patient assessment for angiography, unless mandatory indications f...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章,多中心研究
doi:10.5830/CVJA-2013-017
更新日期:2013-05-01 00:00:00
abstract::We are deeply saddened by the loss of our great teacher Donald Ross, a truly global mentor in cardiac surgery, a friend, a respectful colleague, an admirer, and custodian of our profession, who passed away on July 7, 2014. ...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:
更新日期:2014-07-01 00:00:00
abstract::The biennial Congress of the Pan-African Society of Cardiology (PASCAR) was held in Dakar from 16 to 19 May 2013 under the patronage of his Excellency, Macky Sall, president of the Republic of Senegal. This meeting was remarkable in the diversity of its 700 participants from English-, French- and Portuguese-speaking A...
journal_title:Cardiovascular journal of Africa
pub_type: 社论
doi:
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:Paediatric cardiac services in Nigeria have been perceived to be inadequate but no formal documentation of availability and distribution of facilities and services has been done. OBJECTIVE:To evaluate and document the currently available paediatric cardiac services in Nigeria. METHODS:In this questionnaire...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章,多中心研究
doi:10.5830/CVJA-2016-057
更新日期:2017-01-01 00:00:00
abstract::We present a case of an 85-year-old man with acute myocardial infarction and cardiogenic shock due to left main coronary artery occlusion, with spontaneous dissection of the right coronary artery. ...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:CVJ-21.036
更新日期:2011-05-01 00:00:00