Background/Aim: Paediatric heart failure is a condition that continues to present challenges in management in our environment especially in its treatment and outcomes hence the aim of this study.Materials and Methods: A retrospective analysis of the case notes of all children who were diagnosed and managed for heart failure from January 2019 – October 2021 was undertaken. Data obtained included age, sex, presenting features, primary diagnosis, treatment modalities, duration ofhospital stay and outcomes.Results: A total of 2226 children were admitted over the study period with 67 children diagnosed with heart failure giving a prevalence rate of 3% although only 47 case notes could be retrieved giving a case retrieval rate of 70%. There were 26 (55.3%) males and 21 (44.7%) females (M:F ratio1.2: 1). Mean age of patients was 32.6 months (±52.23) with 28 (59.6%) of them being infants. Bronchopneumonia was the commonest cause of heart failure 31(65.9%) either singly or in combination with acyanotic congenital heart disease followed by severe anaemia in 14 (29.8%). Average duration of hospital stay was 6.9days (±5.08) and average cost of admission was N13,266. Twenty-three patients were discharged (48.9%), while 10 (21.3%) left against medical advice, 2 absconded (4.3%) while 12 (25.3%) died.Conclusion: Heart failure remains an important cause of morbidity and mortality in children in our environment arising from largely preventable causes. Urgent steps such as patient care giver education, immunization and screening for congenital heart disease are needed to reduce its effect on children in our environment.
<p>Endomyocardial fibrosis (EMF) is a poorly-understood idiopathic disorder characterized by the development of restrictive cardiomyopathy. It is a disorder of the tropics and subtropics and was once the second commonest cause of acquired heart disease in Nigeria. Its diagnosis is often made when the disease is advanced and the prognosis is invariably poor at this stage. Reports of EMF have become increasingly rare in recent years and it is frequently misdiagnosed. This report seeks to highlight EMF as a still present and potentially important cause of heart failure in Nigerian children. A 7-year-old male referred to the pediatric cardiology clinic with complaints of abdominal and facial swelling, with no difficulty in breathing and exercise intolerance. Examination revealed a classic “egg-on-stick” appearance. Apex was not displaced and heart sounds were distant. Liver was enlarged but non tender and there was demonstrable ascites. A 2D echocardiography showed massive right atrial enlargement with severe tricuspid regurgitation and fibrosis within the right ventricular cavity which was small. There was a moderate-sized pericardial effusion. Electrocardiogram showed right atrial enlargement with low-voltage complexes. Full blood count showed eosinophilia (20% total white blood cell count). Total serum protein and albumin were reduced. EMF, though increasingly rare, remains an important cause of childhood cardiac morbidity and mortality. A high index of suspicion is critical as the prognosis remains poor.</p><p> </p>
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