Management of heart failure at Chris Hani Baragwanath academic hospital
Date
2016-10-17
Authors
Meel, Piyush
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Heart failure with a reduced ejection fraction (HFrEF) is defined as heart failure with an
ejection fraction of less than or equal to 45%. Guideline-based treatment of HFrEF has
a significant impact on morbidity and mortality. Therefore, the adequacy of
pharmacological treatment of HFrEF at the Chris Hani Baragwanath Academic Hospital
(CHBAH) Medical Outpatients Department (MOPD) was assessed retrospectively
between 2013 and 2014. In addition, the prevalence of aetiologies, comorbidities and
complications of HFrEF were determined.
Mean age of 299 patients was 53 ± 15.4 (55% females). 67.1% received beta blockers,
76.9% received angiotensin converting enzyme inhibitors, 94% received furosemide
and 65% received spironolactone. None were on hydralazine and isosorbide dinitrate
combination therapy. Hypertensive heart disease, human Immunodeficiency virus
associated cardiomyopathy, idiopathic dilated cardiomyopathy and diabetes were the
aetiology of HFrEF in 65%, 23%, 13% and 10.4% of patients, respectively.
In conclusion, treatment of HFrEF was found to be suboptimal. Dissemination of
national HF guidelines, doctors’ education and improved organisation of care are
potential solutions to effect improvement of service and patient care.
Description
A research report submitted to the Faculty of Health Sciences, University of the
Witwatersrand, in partial fulfilment of the requirements for the degree of Masters in
Medicine in the branch of Internal Medicine
Johannesburg, 2016