Cardiomegaly in tropical Africa

Abstract

The term cardiomegaly is found in 5–7% of chest X-ray film evaluations in tropical Africa. However, cardiomegaly is a descriptive term, devoid of any aetiological meaning. Therefore, providing information about the aetiological factors leading to heart enlargement in a group of Africans (Nigerians) was the purpose of this study. In the years 2002–2011, 170 subjects (aged 17–80 years, mean age 42 years) in whom cardiomegaly was revealed by chest radiographs were studied at the Madonna University Teaching Hospital, Elele. The patients underwent echocardiography, electrocardiography, and several appropriate laboratory tests. Arterial hypertension was found to be most frequently associated with heart enlargement (39.4%), followed by dilated cardiomyopathy (21.76%), endomyocardial fibrosis (14.1%), valvular defects (9.4%), cardiac enlargement in the course of sickle-cell anaemia (6.47%), and schistosomal cor pulmonale (3.52%). This study is a contribution to a better aetiological elucidation of cardiomegaly in the tropics and emphasizes the importance of arterial hypertension as one of its causative factors. The dire need for effective treatment of hypertensive patients becomes evident. A high prevalence of elevated blood pressure seems to reflect an impact of civilization-related factors on the African communities.