Clinical Pattern and Outcome of Acute Heart Failure at the Yaounde Central Hospital

Abstract

Background: Acute heart failure (AHF) is a major public health issue. Our objective was to study its clinical pattern and outcome in a reference hospital in Cameroon. Methods: This was a retrospective observational study, including any patient hospitalized for AHF, diagnosed based on clinical and/or ultrasound evidence, in the Cardiology Department of the Yaounde Central Hospital during a period of 3 years from January 1st 2013 to March 30th 2016. Data were entered and analyzed using the statistical software Epi info version 7.1.1.14. Results: A total of 148 patients with AHF were included over a total of 445 admissions. It accounted for 33.3% of admissions. The average age was 61.46 years. The female-male sex ratio was 1.34. The main cardiovascular risk factors were hypertension (54.79%). Dyspnea on exertion was the most prevalent symptom (86%). Hypertensive AHF was the most represented etiopathogenic entity in the series. The main electrocardiographic abnormality found (27.61%) was atrial fibrillation. Cardiomegaly was found in 44.76% of the cases. Hyponatraemia and anemia were found in about a quarter of the cases. On echocardiography, 49.61% of patients had heart failure with a preserved ejection fraction. The main findings were hypertensive heart disease (30.16%) and dilated cardiomyopathy (28.57%). Concerning the management, the most commonly used drugs on admission were loop diuretics; and on discharge, were ACE inhibitors/angiotensin II receptor blockers. Intrahospital mortality was 18.45%. Conclusion: AHF at the Yaounde Central Hospital occurs with severe clinical presentation, complicated by high intra-hospital mortality. Hypertension plays a predominant role both in its onset and in the underlying chronic cardiac involvement.