Prevalence and Aetiology of Heart Failure in Patients Seen at a Teaching Hospital in Ghana

Abstract

Heart failure is a major clinical problem worldwide. It has been recognized as a contributor to cardiovascular disease burden in Africa for many years. There are no data on the prevalence of heart failure in Ghana; and the prevalence of heart failure among patients attending out-patient clinics in Ghana is unknown. This study was designed to determine the prevalence and aetiology of heart failure among patients attending a cardiac clinic in the Department of Medicine, Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana. Medical records of 524 patients were selected from the cardiac clinic, using simple random sampling. The demographic, clinical, chest X-ray, electrocardiographic and echocardiographic characteristics of the patients was examined. Among the 524 patients, 398 of the patients had heart failure according to the modified Framingham criteria for the diagnosis of heart failure; giving rise to a prevalence of 76%. The heart failure patients were aged between 13-97 years with the mean age (± standard deviation) of 56.5 (± 19) years. There were more females (53.6%; n=213) than males (46.4%; n=185). Majority (45%) of the patients had New York Heart Association (NYHA) Functional class 2. The main aetiologies of heart failure were: hypertension (45%; n=179), rheumatic heart disease (23%; n=90), cardiomyopathy (15%; n=58). Other emerging aetiologies of heart failure in Africa seen in these patients were degenerative valvular disease (7.6%; n=31) and ischemic heart disease (2.3%; n=10).