Clinical and Etiological Profile of Congestive Heart Failure: Observations from a Prospective Study

Narasinga Rao Siddanathi; A.Kanaka Mahalakshmi; Ande.Krishna Murthy; Anuradha Argi; Soe Nung; PeelaJagannadha Rao

Volume : VI, Issue : V, May - 2016

Clinical and Etiological Profile of Congestive Heart Failure: Observations from a Prospective Study

Narasinga Rao Siddanathi, A. Kanaka Mahalakshmi, Ande. Krishna Murthy, Anuradha Argi, Soe Nung, Peelajagannadha Rao

Abstract :

 Background: Congestive heart failure (CHF) remains as one of the leading causes of death. In contrast to Western countries where HF is predominantly a disease of the elderly, in India it affects younger age group the most. Though in recent decades ischemic heart disease (IHD) is the commonest cause for HF, rheumatic heart disease (RHD) still remains a significant cause for HF in India due to its over population and low socioeconomic status. There is minimal recent data available on clinical and etiological profile of the CHF in India. Hence, this study was carried out to evaluate the same in Indian patients. Materials and Methods: The study was prospective observational. After obtaining an informed consent, a detailed history was taken, and then the study patients underwent thorough physical examination and detailed investigations. The study included a total of 140 patients aged more than 15 years, admitted to a teaching hospital with clear symptoms and signs suggestive of CHF and satisfying the Framingham criteria for diagnosis of HF. Results: The predominant age group affected was 41–70 years and 15–30 years. Male:female ratio in our study was 2.18:1. Majority of our study patients had most of the symptoms of CHF like eathlessness, palpations, edema, easy fatigability and chest pain. About 67% of the patients were in NYHA class IV and the most frequent physical findings were rales, S3/S4, apical impulse abnormality, murmurs and raised JVP. All patients satisfied the Framingham criteria for diagnosis of definite CHF. Anemia and hyponatremia were the predominant laboratory abnormalities and poor prognosticators. Congestive heart failure triad, ST elevation/ LV strain and atrial fiillation were the predominant ECG abnormalities. Cardiomegaly was the most frequent chest X–ray abnormality.Ischemic cardiomyopathy(28%) and Chronic Rheumatic heart disease(CRHD)(24%) were the most frequent Etilogies of HF on 2D ECHO Cardiography.About 42% of the patients received digoxin+ACEI+furosemide as treatment. Conclusion: Although IHD is the predominant cause of HF, still chronic RHD continues to be the second most important etiological factor and hypertension stands third. In the current study, the highest frequency of HF was observed in the age groups 41–70 years and 15–30 years. Chronic rheumatic heart disease was more common in females and in younger age groups while CAD occurred exclusively in males and in older age groups. 2–D Echocardiography is essential for diagnosis and assessment of prognosis of HF. Most of the study patients (83%) recovered within 1–2 weeks and mortality rate was found to be 5%.