No abstract

Introduction Thyroid disease is an independent predictor of heart failure in patients. This study aimed to investigate the prevalence of thyroid dysfunction among patients with heart failure in Mogadishu, Somalia. Methods From January 2019 to January 2021, a total of 250 patients diagnosed with heart failure admitted to the cardiology outpatient and emergency departments were evaluated retrospectively. The demographic characteristics, the cause of heart failure, and the kind of heart failure were recorded. Patients were categorized into subclinical hypothyroidism, hypothyroidism, low T3 syndrome, subclinical hyperthyroidism, and hyperthyroidism. Results A total of 250 heart failure patients. The prevalence of thyroid dysfunction among heart failure patients was 35.6%. The mean age of the patients was 59.8±14 years. Males outnumbered females by 159 (63.2%). The prevalence of thyroid dysfunction was 35.6%. Out of the 250 patients that were examined, most of the patients 30(33.3%) had subclinical hypothyroidism. 23 (25.6%) had overt hypothyroidism, 15 (16.7%) had overt hyperthyroidism, 20 (22.2%) had low T3 syndrome, and two cases had subclinical hyperthyroidism. Regarding the gender status of the thyroid dysfunction, 43(48.3%) were male, and 46(51.7%) were female. Regarding heart failure types among thyroid dysfunction patients, most patients were HFrEF (n=64, 71.9%), and 25(28.1%) were HFpEF. Patients with heart failure and reduced ejection fraction (HFrEF) were more likely to have thyroid dysfunction than those with preserved ejection fraction (p = 0.012). Regarding comorbidities among heart failure patients with thyroid dysfunction, approximately half of the patients had hypertension (40.4%). Conclusion Thyroid problems are one of the most prevalent endocrine abnormalities in our practice. Subclinical hypothyroidism was the most common type of thyroid dysfunction among this population. We suggest that thyroid function be evaluated with cardiac function in patients with heart failure and followed up and treated together with heart failure.

Background This study aims to examine the prevalence and related factors of pulmonary hypertension (PHT) in patients on hemodialysis (HD) at the only referral institution in Somalia. A total of one hundred and forty-three patients  who had received regular HD therapy for at least three months and underwent transthoracic echocardiography (TTE) were included in the study. Patients with a systolic pulmonary artery pressure (sPAP) value > 35 mmHg at rest on TTE were considered having PHT. The relationship of TTE parameters, demographic, and clinic characteristics of participants with PHT were evaluated. Results The number of patients with PHT was 73 (51%). The mean age was 54.2 ± 18.4 years. The majority of patients were 65 years of age or older. (n: 46, 32.2%) and 65 (45.5%) were male. Median sPAP was found to be 35 mmHg. Systolic pulmonary artery pressure was positively correlated with right atrium (RA) diameter (r: 0.6, p < 0.001) and negatively correlated with left ventricular ejection fraction (LVEF) (r: − 0.4, p < 0.001). In addition, LVEF, RA diameter, presence of pericardial effusion (PE) were found to be independent predictors of PHT. Conclusions Pulmonary hypertension has a relatively high prevalence in end-stage renal disease (ESRD) patients on regular HD. Besides, the presence of PE and certain right and left heart parameters were independently associated with PHT.

Background: Heart failure is one of the major global health problems that we face today, worldwide. The main objective of our study is to evaluate the spectrum and prevalence of renal dysfunction among heart failure patients in Mogadishu, Somalia. Methods: The design of the study is a retrospective descriptive study aimed at heart failure patients who presented to the largest tertiary care center in southern somalia between January 2021 to september 2021. Demographic data, co-morbidities, types of heart failure, causes of heart failure and the presence or absence of renal dysfunction were analysed. Results: Overall 180 heart failure patients were enrolled in the study. The mean age of the participants was 62.26±14 years. Regarding the age group, patients aged between 61-80 years was the most abundant participants with (n=87, 48.3%). Regarding the type of heart failure in our study, HFpEF was the most common type in our respondents with frequency of (n=85, 47.2%). When analysed the cause of heart failure among patients; hypertension was the most common cause of heart failure (n=90, 50%). Also, hypertension was the most common co-morbidity among our patients (n=106, 59%), followed by coronary artery diseases (n=50, 28%). The prevalence of renal dysfunction in heart failure patients was (n=37, 20.6%). Our analysis showed that among the 37 renal dysfunction patients, 12.3% of them (n=22) were chronic renal failure while the remaining 8.3% (n=15) had acute renal failure. We found a significant correlation between gender and renal dysfunction in heart failure patients with (95% CI: 0.098-0.574, OR: 0.237, p value: <0.001). Males were 2 and half times more likely to develop renal failure than females. Conclusion: we found that the prevalence of renal dysfunction in heart failure patients is 20.6%. It was more prevalent in males and elderly population.

Endocarditis is a life-threatening infection of the endocardium (inner lining of the heart). It usually affects the left-sided valves more than the right-sided valves and presents classically with a new murmur, fever, and peripheral stigmata. Though in the modern era, we have better antibiotics, better diagnostic imaging, and surgery that might cure infectious endocarditis (IE), it still carries significant mortality and morbidity. Here we present a 52-year-old male patient with hypertension and ischemic heart disease who presented with shivering, fever, and confusion for 2 days, fourteen days after cardiac intervention (PCI). Further trans-esophageal echocardiography was done due to the patient’s fulfillment of three minor and one major of Duke's criteria. Trans-esophageal echocardiography revealed flailing posterior mitral valve leaflets, 1.1 x 0.60 cm of vegetation, and severe eccentric mitral regurgitation. The patient was managed with vancomycin and gentamicin and referred to the cardiovascular surgery center. Post-PCI infective endocarditis is a rare and often missed diagnosis, so there should be a high level of suspension for those who present with signs and symptoms compatible with infective endocarditis.

No abstract

Truncus arteriosus (TA) is a relatively uncommon cyanotic congenital cardiac anomaly accounting for 1.3% of all congenital cardiac malformations. TA associated with an ascending aortic aneurysm is an extremely rare congenital cardiovascular abnormality. A 15-year-old male presented with shortness of breath and cough for 2 weeks. Radiological examinations showed that the ascending aorta and main pulmonary arteries originate from a single truncus with ascending aortic aneurysm. TA has a poor prognosis if remain unrepaired and surgical intervention is necessary to avoid severe pulmonary vascular occlusive disease.

No abstract