Clinical profile and echocardiographic findings of patients with cardiomyopathy at a tertiary care hospital

Abstract

Cardiomyopathy is a primarily disorder of the heart muscle that causes abnormal myocardial performance and is not the result of disease or dysfunction of other cardiac structures. It is an important and heterogeneous group of diseases. We conducted this study at a tertiary care center with the aim to study the clinical profile and echocardiographic findings of cardiomyopathy patients. This study was a descriptive cross-sectional study conducted over a period of 18 months from September 2013 to August 2015. 50 consecutive patients of cardiomyopathy, attending out-patient department and admitted in tertiary care hospital and meeting inclusion and exclusion criteria were selected. Microsoft Office® Excel software was used for data entry and IBM SPSS 18 was used for descriptive statistics. In our study maximum number of patient belonged to age group of 30 to 49 years (n= 25, 50%). The mean age of presentation was 45.16 years where as mean age for male patients was 45.68 and for female patients was 45.18 years. Male to female ratio was 3.16:1.Dilated cardiomyopathy (n= 26, 52%) was most common type of cardiomyopathy. In DCM patients most common symptom was dyspnea (n=26,84.6%) and most common sign was pedal edema (n=14,53.8%). Among HCM patients, dyspnea (33.3%) was the commonest presenting complaint but large number of patients were asymptomatic (28.6 %) and commonest sign was pedal edema (n=5, 23.8%). In DCM patients common ECG findings include Left ventricular hypertrophy (34.6%), Left axis deviation (30.8%), Left bundle branch block (23.1%), atrial fibrillation (23.1%), sinus tachycardia (23.1%) and ventricular premature complex (11.5%). Common ECGfinding in HCM patients were Left ventricular hypertrophy (47.6%), giant T wave inversion in V2- V6 (42.9%), Left axis deviation (33.3%), ventricular premature complex (14.3%), Left bundle branch block (9.5%) and atrial fibrillation (9.5%). Echocardiography findings for DCM patients in our study were, LV systolic dysfunction (Mean LVEF: 26.3±10.3%), Global hypokinesia, Dilation of all four chambers (Mean LVIDd: 66.4±3.4mm and LVIDs 54.6±3.5mm), Mitral regurgitation (30.8%), Pulmonary hypertension (38.5%), Pericardial effusion (11.5%) and LV thrombus (7.7%).Echocardiographic findings in HCM patients showed marked LV hypertrophy, LVOT obstruction (38.1%), Asymmetric septal hypertrophy (52.4%), Apical hypertrophy (47.6%) and Systolic anterior motion of mitral valve (23.8%). In HCM patients, most common pattern of LV hypertrophy was pattern 3 (42.8%) i.e. Apical hypertrophy with any other segment hypertrophy followed by Pattern 1 (38.1%) i.e. Septal hypertrophy alone, pattern 2 (14.3%) i.e. septal and other segment hypertrophy excluding apex; and pattern 4 (4.8%) i.e. apical hypertrophy alone.