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Precipitant profile of acute heart failure: experience of a tertiary level cardiac centre in Sri Lanka
  1. Anne Thushara Matthias,
  2. Ruvan Ekanayaka
  1. Cardiology Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka
  1. Correspondence to Dr Anne Thushara Matthias, Dr C V S Corea Mawatha, Hokandara Road, Thalawathugoda, Sri Lanka; thushara.matthias{at}gmail.com

Abstract

Introduction and objectives Heart failure (HF) is a common cause of hospitalisation in most countries. Data on acute precipitants of HF and hospitalisation is not available in Sri Lanka.

Background and methods A prospective study of 100 sequential admissions with HF to the cardiology unit (National Hospital of Sri Lanka) to describe the precipitants and clinical outcome of HF.

Results Fifty-eight male and 42 female admissions were studied. Mean age was 60.66 years. Mean hospital stay was 5.5(SD 4.6) days. Sixty had de novo HF and 40 had pre-existing HF.

The most common identifiable precipitants were acute ischaemia 37 (37%), anaemia 41 (41%), respiratory tract infection 10 (10%), arrhythmia 11 (11%), worsening renal function 11 (11%) and alcohol 5 (5.7%). Non-adherence to medication 4 (4.6%), smoking 3 (3.9%), exposure to environmental stress 3 (3.4%) and uncontrolled hypertension 1 (1%) were also observed as precipitants. The most common arrhythmia was atrial fibrillation. Out of 34 patients in whom angiotensin-converting enzyme inhibitors or angiotensin-converting enzyme receptor blockers were indicated, 11% were not on the drug. Among 29 patients in whom spironolactone was indicated, seven patients were not on the drug.

Conclusions Most precipitating factors of HF are preventable. Early identification and prevention of anaemia, preventing respiratory tract infection by vaccination, aggressive revascularisation for patients with ischaemia, monitoring of renal functions, and patient education regarding drug and diet compliance, would reduce the number of admissions.

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