Spectrum of cardiovascular disorders in a national referral centre, Ghana

Abstract

Objective: To determine the pattern of cardiovascular disorders in Ghana.
Design: A four-year prospective study.
Setting: National Cardiothoracic Centre (NCTC), Korle-Bu Teaching Hospital, Accra, Ghana.
Subjects: Seven hundred and eight subjects with cardiovascular disorders referred to the NCTC, Accra, were evaluated clinically and with ancillary laboratory tests, chest x-ray, and electrocardiography. Subjects were also assessed with the aid of two-dimensional
echocardiography with doppler and colour flow mapping.
Results: Hypertensive heart disease(n=133), rheumatic heart disease(n=123), idiopathic cardiomyopathy(n=103), congenital heart disease(n=90) and coronary artery disease(n=80) were the major causes of cardiovascular morbidity. The mean age of the subjects was 41.6 ± 0.8 years. The male to female ratio was 1.3:1.0. The peak incidence of cardiovascular disease occurred in the fifth decade. Subjects with coronary artery disease were relatively older and had the highest incidence of hypertension(66.3%), diabetes(22.5%),
smokers(11.8%), hyperlipidaemia(8.8%) and regular alcohol use(12.5%). The commonest rheumatic valvular lesion was mitral regurgitation. Dilated cardiomyopathy was the commonest form of cardiomyopathy(n=56). Hypertrophic cardiomyopathy and
endomyocardial fibrosis were seen in 25 and 22 subjects respectively. Ventricular septal defect, atrial septal defect, tetralogy of Fallot and patent ductus arteriosus were the commonest congenital lesions. The major cardiovascular disorders in children were congenital
(n=27) and rheumatic heart(n=11). Idiopathic cardiomyopathy(n=1) was rare in children.

Conclusion: Major causes of cardiovascular morbidity in Ghanaians were hypertension, rheumatic heart disease and cardiomyopathy. Congenital and rheumatic heart diseases were the commonest cardiovascular disorders in Ghanaian children. Idiopathic cardiomyopathy was rare in children.