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An Echocardiographic Evaluation of Dilated Cardiomyopathy in a Tertiary Care Hospital
Raj Kumar Thapa1, Kanchan K C2, Rishi Khatri1
1Department of Medicine, Shree Birendra Hospital, Chhauni, Kathmandu, Nepal.
Insights
Dilated cardiomyopathy, a common heart muscle disease, often presents as congestive heart failure and is frequently underdiagnosed. Echocardiography is key for detecting this condition, especially in elderly males.
Area of Science:
- Cardiology
- Cardiovascular Diseases
- Medical Diagnostics
Background:
- Cardiomyopathies encompass heart muscle diseases arising from genetic factors, myocyte injury, or tissue infiltration.
- Dilated cardiomyopathy (DCM) is the most prevalent phenotype, often resulting from various cardiac insults.
- DCM is frequently underdiagnosed due to limited accessibility to echocardiography, histopathology, and genetic evaluations.
Purpose of the Study:
- To analyze echocardiographic findings in patients diagnosed with dilated cardiomyopathy.
- To assess the prevalence and clinical characteristics of DCM in a tertiary care military hospital setting.
- To highlight the diagnostic utility of echocardiography in identifying DCM.
Main Methods:
- An analytical cross-sectional study was conducted using hospital data from 65 DCM patients.
- Echocardiographic evaluations were performed over a six-month period (February-July 2018).
- Data were analyzed using Microsoft Excel 2010 and IBM SPSS 21, excluding pediatric patients.
Main Results:
- The study included 65 patients (61% male, 39% female), with the elderly (61-75 years) being most affected.
- Congestive heart failure was the primary presentation in 49% of patients.
- Echocardiography revealed mild Left Ventricle dilation in 55% and reduced Ejection Fraction (average 39.6%) in the majority, with no significant sex or age-related differences in EF.
Conclusions:
- Dilated cardiomyopathy is the most common cardiomyopathy, frequently presenting with congestive heart failure.
- The condition is often underdiagnosed in the region.
- Echocardiography serves as an effective diagnostic tool for identifying dilated cardiomyopathy.
Introduction:
Cardiomyopathies are diseases of heart muscle that may originate from genetic defects, cardiac myocyte injury or infiltration of myocardial tissues. Dilated cardiomyopathy is the most common phenotype and is often a final common pathway of numerous cardiac insults. Mostly it remains unknown in the absence of echocardiography, histopathology and genetic evaluation. Though common it is underdiagnosed with not much of data available in our setup.
Methods:
This study was analytical cross-sectional study of hospital data on Echocardiographic findings in 65 patients of DCM visiting cardiology unit for Echocardiographic evaluation from 1st of February to 31st July 2018 for the period of six months in Shree Birendra Hospital, a tertiary care military hospital at Chhauni, Kathmandu. Pediatric age group patients and those who refused to give consent were excluded. Data obtained were entered in Microsoft Excel 2010 and analyzed by IBM SPSS 21.
Results:
Among 65 patients enrolled 40 (61%) were male and 25 (39%) female with male to female ratio of 1.6:1. Elderly people (61-75 years) with an average age of 65 were commonly involved and they presented mostly with congestive heart failure, 32 (49%). Echocardiographic evaluation showed 36 (55%) with mildly dilated Left Ventricle (5.6-6.0cm). Majority had reduced Left ventricular systolic function with an average Ejection fraction (EF) of 39.6%. No significant difference between male and female with the average EF% (P=0.990) and there was no significant relation between age and average EF% (P=0.091).
Conclusions:
Dilated Cardiomyopathy is the commonest cardiomyopathy phenotype mostly presenting with congestive heart failure. It is often underdiagnosed in our part of the world, however echocardiography will easily detect the condition.
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