Spectrum of Echocardiography Abnormalities among 168 Consecutive Referrals to an Urban Private Hospital in South-Western Nigeria

Abstract

Trans-thoracic echocardiography (TTE) is an important non-invasive cardiac examination that provides structural and functional information. It is useful in the diagnosis of cardiac diseases and often guides the management and follow-up of patients with cardiovascular diseases (CVD).The study aimed to present an audit of the echocardiograms performed in an urban private hospital over a two-year period in order to define the pattern of cardiac diseases in our center. Echocardiogram reports of 168 consecutive patients performed between May 2011 and April 2013 at an organized private sector hospital in Lagos, south-west Nigeria were reviewed. Studies were performed with a Toshiba Nemio XG ultrasound machine. The data obtained were analyzed for mean age, sex, clinical indications, and echocardiographic diagnosis in the study subjects.A total of 168 echocardiography reports were examined, comprising of 92 males (54.8%) and 76 females (45.2%). The age range of the subjects was 10–76 years (mean 42.5 ± 12.1 years). The commonest indication for echocardiography was systemic hypertension and hypertension related causes (38.1%), followed by abnormal resting electrocardiogram (14.9%). Routine annual medical screening was the next most common indication, representing 13.1% of the indications for echocardiography. The other indications are as presented in Table 1. The echocardiogram was normal in 64.3% of the subjects. The commonest abnormality detected was hypertensive heart disease (HHD); accounting for 9.6% of the subjects studied. Isolated atrial enlargement (left, right, or bi-atrial) was the next most common abnormality accounting for 6% of the echocardiographic diagnosis. Pulmonary hypertension was the next most common diagnosis accounting for 4.8% of our findings. The other echocardiographic diagnoses are as listed in Table 2.Hypertension represents the commonest indication for echocardiography. Normal echocardiogram was the commonest echocardiographic finding while HHD was the commonest echocardiographic abnormality. The prevalence of ischemic heart disease by echocardiography was 2.4%. There was no case of rheumatic heart disease (RHD). The prevalence of hypertrophic cardiomyopathy (HCM) was 1.2%. Ease of access to echocardiography may influence the findings in an echocardiographic audit and policy makers should incorporate appropriateness criteria into their guidelines for reimbursement.

2011 appropriate use criteria audit of an echocardiography lab in South Western Nigeria

“…This is comparable to the findings of Oyedeji et al, where hypertension was the most common indication for ECHO. 10 The percentage of 16.1% is however much lower than that in Cuspidi et al (30.4%). 11 This is likely due to the fact that Hypertension and Article hypertensive heart disease are separate indications in this study (as compared to theirs), with both having a combined prevalence of 24.6%.…”

Indications for Echocardiography and Confirmation Rates of Cardiovascular Diseases: Experience of a Specialist Cardiac Outpatient Clinic in Kumasi, Ghana

“…We found a prevalence of 4.24%, whereas previous research found frequencies ranging from 0.4% to 2.4%. [ 35 ] The low risk of VHD may be owing in part to the study's inclusion of only adults.…”

Hypertrophic Cardiomyopathy Diagnosis and Treatment in High- and Low-Income Countries: A Narrative Review

“…Low-income countries struggle with lower income per capita and less Magnetic Resonance Imaging (MRI) units per million population, for example, Mexico, Ghana, Sub-Saharan Africa, Colombia, and India have 2.9, 0. [72]. In a country where there are limited diagnostic facilities, echocardiograms could be used for the classification of HCM and for monitoring patients [73].…”