Abstract
Heart failure (HF) is an important cause of morbidity and mortality in sub-Saharan Africa and indeed worldwide. The management of this condition has largely been thought to be within the domain of the Physician with the Surgeon having little or no role to play. The commonest cause of HF that may require surgical intervention is rheumatic valvular heart disease especially in the young age group while ischaemic heart disease still remains at the low rung of the ladder and interestingly, hypertrophic cardiomyopathy is becoming common. Most of the literatures reviewed failed to identify pericardial diseases, though it ranked topmost in the face of tuberculosis and HIV infections in the sub-region, and the other non-cardiac structures as important causes of HF which is amenable to surgical intervention. Equally, what have not been clearly identified are the surgical aspects; indeed its sub-classifications into heart and non-heart causes have hitherto not been documented. Even though these lists from this review are not exhaustive of the numerous unidentified causes of surgical HF, this would act as stimulus for further and extensive documentation of guideline for the recognition of these sub-classifications of HF amenable to surgery.
Highlights
Heart failure (HF) is a clinical syndrome caused by any disorder involving the pericardium, the muscles, valvesHow to cite this paper: Okonta, K.E. (2014) Epidemiology and Pathophysiology of Acquired Heart Failures Amenable to Surgical Interventions in the Sub-Saharan Africa
In some autoimmune diseases it has been noted to be associated with mitral valve prolapsed [59]. This is the first review of this kind, albeit, some clinicians may not agree with all of the above enumerated causes of surgical HF
Surgical HF is any clinical condition that prevents the proper pumping out of blood from the heart chambers or the heart does it at the expense of increased venous return and of which surgery may deservedly effect a cure
Summary
Heart failure (HF) is a clinical syndrome caused by any disorder involving the pericardium, the muscles, valves. (2014) Epidemiology and Pathophysiology of Acquired Heart Failures Amenable to Surgical Interventions in the Sub-Saharan Africa. Okonta or vessels which results in defective heart filling at diastole or impaired heart contraction or emptying with inability to pump adequate amount of blood to support tissue metabolism, or to be able to do so at an elevated filling pressure [1]. The heart structures can be sub-classified into: the pericardium, the myocardium, the coronary arteries, the valves, the conductive tissues. The non-heart structures, outside the heart, that when affected may result in HF requiring surgical interventions, are the thyroid gland in thyroid diseases, peripheral vessels disorder like large arterio-venous fistulae, the pleural space and the lung diseases and off course postoperative low cardiac output. There is no published literature on acquired HF requiring surgical intervention in SSA [2] and those classifications and sub-classifications have not hitherto been done and this is the first review
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