Results of echocardiographic examinations in a regional hospital of central Sudan

Abstract

Sixty-seven patients were examined with a small portable echocardiograph in Wad Medani Teaching Hospital in central Sudan. The cardiac alterations detected in the referred patients, namely valvular disease and pericardial effusion, suggested a high prevalence of inflammatory heart disease in this area. Other findings were dilatative cardiomyopathy, congenital heart disease, mitral valve prolapse and a cardiac mass. Echocardiographic examination of patients with advanced hepatosplenic schistosomiasis revealed no evidence of cardiac alterations or abnormal right heart function. For echocardiography a general purpose ultrasound scanner, as defined by the World Health Organization, was used, additionally equipped with M mode facilities. It was concluded that echocardiography is applicable even in remote tropical areas and that its value, considering costs, therapeutic consequences and clinical benefit in developing countries, can be substantial. It was particularly helpful with pericardial disease.

Is ultrasound a useful adjunct for assessing malaria patients?

“…However, since splenomegaly persists frequently also after cure, and since splenomegaly is not specific for malaria, the practical value of this finding is questionable. In certain cases, ultrasonography may contribute to differential diagnosis for those diseases involving the liver and/or the spleen which present characteristic ultrasonographic features: these include not only liver cirrhosis and malignancies but also infectious diseases occurring more frequently in endemic areas, such as echinococcosis, tuberculosis, bacterial endocarditis, chronic hepatosplenic schistosomiasis, amoebic liver abscess and acute fascioliasis (Richter et al 1990(Richter et al , 2003. Ultrasonography is indicated when splenic rupture is suspected (de Aguirre et al 1998;Yagmur et al 2000;Davies and Venkatesan 2002;Rapp et al 2002).…”

Early Right Cardiac Dysfunction in Patients with Schistosomiasis Mansoni

“…A recent study demonstrated that PH patients with schistosomiasis may represent up to 30% of PH patients followed at reference centers in Brazil 25 . Furthermore, schistosomiasis is common in remote areas of less developed countries where health systems are not adequate and modern echocardiographic technologies are scarce 24,26 …”

“…Regarding the diagnosis of early RV dysfunction in chronic SM, almost no information is available 5 . It is known that chronic cor pulmonale in hepatosplenic SM is uncommon 6,24,26,35 …”

“…25 Furthermore, schistosomiasis is common in remote areas of less developed countries where health systems are not adequate and modern echocardiographic technologies are scarce. 24,26 TR for the Diagnosis of PH: The use of the peak velocity of the TR jet to estimate systolic pulmonary pressure has been shown to correlate with pulmonary artery systolic pressure, although some papers have shown that the TR derived measurement can overestimate the prevalence of PH. 6,[27][28][29] In the hepatosplenic form, the evaluation of the inferior vena cava size and its degree of collapse with respiration can be impaired because of portal hypertension.…”

“…5 It is known that chronic cor pulmonale in hepatosplenic SM is uncommon. 6,24,26,35 Both RVEDA and RAA showed some difference between the schistosomiasis forms studied. In a study of 32 patients with end-stage lung disease presenting for lung transplantation, RVEDA was the most accurate echocardiographic parameter of RV size, with a correlation of 0.88 with magnetic resonance imaging.…”