Echocardiography in patients with chest x-ray diagnosis of cardiomegaly at an academic hospital in Zambia

Abstract

Background: Cardiomegaly is the most diagnosed condition on Chest X-ray (CXR) at the study site. However, little is found on the association between cardiomegaly and echocardiography (ECHO) findings at this site. The main objective of this study was to establish whether there is an association between cardiomegaly diagnosed on a CXR and ECHO findings of the same patient.

Methods and Materials: This retrospective study involved the retrieving of data from files of 124 patients who had cardiomegaly diagnosed on CXR and had undergone an ECHO examination. The study sought to establish whether there is an association between cardiomegaly diagnosed on a CXR and ECHO findings of the same patients.

Results: There was a positive association between cardiomegaly diagnosed on CXR and ECHO findings and the association was significant at 5%. In addition, there was also a strong association between age and cardiomegaly and the association was also significant at 5%. The Chi-square results at 5% level of significance showed that there is not enough evidence to suggest an association between gender and cardiomegaly. Therefore, both women and men have an equal chance of acquiring cardiomegaly. Left Ventricular Diastolic Dysfunction was the most prevalent condition, having been seen in more than 50% of patients. Most of the conditions identified in patients were very severe. In addition, 70% of these patients had a raised blood pressure with 43% having severely raised blood pressure.The test results also showed that 66% of patients in the sample had increased blood flow on Doppler measured at certain points of the heart with 6% of the patients having severely increased blood flow. Patients with increased blood flow showed an increase in blood pressure with those with severe increased blood flow showing a strong positive association with severe high blood pressure.

Conclusion: These findings show that there is a strong association between cardiomegaly diagnosed on CXR to ECHO findings of the same patient. Therefore, echocardiography should be done on all patients diagnosed with cardiomegaly on CXR. In addition, priority should be given to elderly patients (65 years and above) as most of these had both severe cardiomegaly and one or more cardiovascular diseases.