Study of clinical and etiological profile of congestive heart failure in a tertiary care hospital

 

 

Abstract              Background: Heart failure is a common cardiovascular disease with high morbidity and mortality. Important risk factors include coronary artery disease, hypertension, diabetes mellitus, valvular heart disease and cardiomyopathies. Patients with HF in India are younger, sicker and have a much higher morbidity and mortality as compared to their western counterparts. Heart failure is associated with shorter life expectancy, increased frequency of hospitalization and poor quality of life (QoL), and is a major public health challenge in India. Present study was aimed to evaluate clinical and etiological profile of congestive heart failure patients in a tertiary care hospital. Material and Methods: This prospective, observational study was conducted in department of medicine, on patients aged > 18 years old with a diagnosis of heart failure. Patients with chronic obstructive pulmonary disease, congenital heart disease were excluded. Results: Total 112 patients were included in present study. Heart failure was commonly seen after 45 years age (71 %) and in male patients (58 %). Male to female ratio was 1.4:1. Mean age of patients was 53.91 ± 11.23 years. Hypertension (67%), coronary artery disease (53%), diabetes mellitus (47%), hyperlipidemia (42%) was present commonly in heart failure patients. Dyspnea (97%), Orthopnea (77%), Paroxysmal nocturnal dyspnea (61%), Easy fatiguability (58%), Chest pain (47%), Palpitation (35%) were most common symptoms noted in heart failure patients. Common clinical signs were basal lung crepitations (93%), peripheral edema (58%), raised JVP (44%), gallop rhythm (34%) and ascites (19%). Ischemic heart disease (56%), hypertensive heart disease (22%), cardiomyopathy (11%) and valvular heart disease (8%) were most common etiology of heart failure in present study. In present study acute coronary syndrome (26%), non-compliance with medications (19%), uncontrolled hypertension (15%), infection (13%) and unknown (9%) were common precipitating causes of heart failure. We noted 14% mortality in present study. We advised heart transplant in 8% patients. Conclusion: Heart failure is nowadays routinely seen, especially in age above 45, with co-morbid factors like coronary artery disease, hypertension, diabetes mellitus, cardiotoxic drugs, valvular heart disease and obesity.

Key Words: heart failure in India, ischemic heart disease, hypertension, precipitating conditions