Dilated Cardiomyophthy Experience in Pakistan

Abstract

MATERIALS AND METHODS: Between January, 1979 and May, 1983, a total of 7360 Echoes were performed at the NICVD, out of which 80 cases had Echo confirmed diagnosis of Dilated Cardiomyopathy. Only 45 of these 80 cases were thought to be truly idiopathic on clinical and laboratory grounds and had complete records available and were subjected to retrospective analysis. RESULTS: Out of 80 Echo confirmed cases of Dilated Cardiomyopathy, 18 were excluded due to incomplete clinical records and technically difficult Echo study. Another 17 patients, on detail review of history, physical examination and available investigations revealed secondary etiology (Coronary Heart Disease in 14, Myocarditis in 2 and Hypertensive Heart Disease in one patient). Early closure of aortic valve suggestive of low forward aortic flow was present in 44% of cases. “Fish Mouth” appearance of mitral valve was seen in all cases. DISCUSSION: Dilated Cardiomyopathy represents one of the neglected heart diseases in Pakistan. The reasons for this may have been the assumption that it is a rare problem. It may also have been overlooked and mis-diagnosed for lack of interest because its treatment remains unsatisfactory. It is therefore recommended that a detailed prospective study is done preferably with all cases under going cardiac catheterization and coronary angiography, endomyocardial biopsies, and, autopsy where possible, to further characterize this disease entity in Pakistan with the ultimate hope that curative treatment will follow.