Cardiomyopathies: Presentation and Complications in Children at Dera Ismail Khan

Abstract

Background: Cardiomyopathies are a group of non-inflammatory conditions of myocardium leading to cardiac dysfunction. This study was conducted to see the presentation and complications of cardiomyopathies in children at Dera Ismail Khan.

Material & Methods: This descriptive case series was carried out at Department of Paediatrics, DHQ Teaching Hospital, Dera Ismail Khan, from January 2007 to December 2008. All cases admitted with congestive heart failure were investigated. After history and examination, investigations including CXR, ECG and Echocardiography were performed. Other relevant investigations were also performed as and when indicated. Both already and newly diagnosed cases were included in the study. Exclusion criteria were cause of CCF other than cardiomyopathy and/or a normal echocardiography. Data was analyzed for age, sex, presentation, complications, associated conditions, and mortality.

Results: Sixty patients were admitted with cardiomyopathy during the study period. All these patients initially presented with congestive cardiac failure. Sixteen (27.6%) of these were being treated as wheezy bronchitis/asthma by local doctors. Commonest type was dilated CMP 54(90%). Other less common types were hypertrophic CMP 4(6.6%) and restrictive CMP 2(3.3%). Common complications included failure to thrive 35(58.3%), mitral regurgitation 8(13.3%), pericardial effusion 7(11.7%), hemiplegia 5(8.4%), pulmonary hypertension 4(6.7%), arrhythmias 2(3.4%), pleural effusion 2(3.4%), infective endocarditis 1(1.1%), shock 1(1.1%) and death 1(1.1%).

Conclusion: Commonest presentation of cardiomyopathy is congestive cardiac failure, but repeated wheezy attacks are also common during early stages of the disease. Commonest complications are mitral regurgitation, pericardial effusion, stroke and failure to thrive.