Descriptive Study of Patients with Heart Failure in Nangarhar University Teaching Hospital

Abstract

Failure of the heart to meet the metabolic demands of the body bears numerous complications subsequently leading to death. The overall aim of the study was to find out heart failure prevalence in patients visiting Nangarhar University Teaching Hospital and further elaborate it. It was a descriptive retrospective study including both male and female patients aging 18 years and more during six months at Nangarhar University Teaching Hospital located at Nangarhar province of Afghanistan. Out of 13077 patients, only 367 (2.8%) patients of whom 207 (56.6%) and 159 (43.4%) were females had heart failure. Heart failure cases increased with advancing age as there were 8.2% cases in age group 20-39 years, 11.5% cases in 40-49 years, 26.2% cases in 50-59 years, and 54.5% cases in patients with age of 60 years and over. In fact, 335 (91.1%) patients had exertional dyspnea, 102 (27.8%) patients had orthopnea, 23 (6.3%) patients had pulmonary edema. Most abundant physical signs were neck vein distention (56.6%), lower limb edema (52.4%), and pulmonary rales (31.1%), followed by gallop rhythm (12.5%) and hepatomegaly (5.1%). In addition, 42.8% patients had mildly reduced ejection fraction while 29.8% patients had moderately reduced ejection fraction and 16.4% had severely reduced ejection fraction. Moreover, 28.7% patient had regional wall motion abnormality on echocardiography while 15.8% patients had dilated cardiomyopathy, 13.9% patients had valvular heart disease, and 10.6% patients had pulmonary arterial hypertension. Heart failure was a common disease in Nangarhar University Teaching Hospital; more specifically in females and patients with advanced age. In fact, echocardiographic findings revealed ischemic heart disease, dilated cardiomyopathy, and valvular heart disease as the leading associated factors. Measures should be taken to reduce risk factors and raise social awareness about heart failure in order to reduce its prevalence and subsequent morbidity, mortality, and expenditure.