Etiology of congestive heart failure at a tertiary care hospital

ABSTRACT Objective To determine the frequency of various etiological factors responsible for causing congestive heart failure (CHF) in a tertiary care hospital in Peshawar, Pakistan. Subjects and Methods This retrospective, observational, single center study was conducted in Department of Medicine, Khyber Teaching Hospital, Peshawar from October 2009 to May 2010 and included 100 patients of CHF. After history and clinical examination, a diagnosis of CHF was established according to Framingham criteria. All patients had a 12-leads electrocardiogram (ECG), echocardiogram and serial blood tests. Results Out of 100 patients, 60% were male and 40% female with mean age of 54 years. Ischemic heart disease (IHD) was present in 35% of patients, hypertension in 27%, rheumatic heart disease (RHD) in 13%, cardiomyopathies in 11% and congenital heart disease in 6%. Conclusion IHD, hypertension, valvular heart disease and cardiomyopathy were the major causes of CHF in our patients. (Rawal Med J 2010;35: ). Key words: Electrocardiogram, echocardiogram, congestive cardiac failure. INTRODUCTION Congestive heart failure (CHF) is a condition that impairs the ability of the heart to fill with or pump a sufficient amount of blood through the body.1 More than 550,000 patients are diagnosed with CHF for the first time each year in US.2 The prevalence of CHF is known to rise with increasing age and affects about 10% of the population older than 75 years of age.3,4 According to Framingham study, major criteria are paroxysmal nocturnal dyspnea, orthopnea, raised jugular venous pulse, lung crepitations, cardiomegaly and gallop sounds. Minor criteria were ankle edema, night cough, dyspnea on exertion, hepatomegaly, pleural effusion and tachycardia.5 The diagnosis of predominantly systolic CHF required a minimum of two major or one major plus two minor criteria and LVEF