Heart Failure in an Emergency Room Setting.

Abstract

Summary: Heart failure was observed in 91 (3%) of 2766 children who were admitted into Children's Emergency Room, University College Hospital, Ibadan, during a 12-month period. The main causes were acute lower respiratory tract infections intrin sic heart diseases and anaemia. They accounted for 35.2%, 35.2% and 26.3% of the 91 cases respectively. Bronchopneumonia and cardiac malformations precipitated heart failure mainly in infants whereas 71% of the children with anaemic heart failure were aged between one and five years. The mean haematocrit in the latter patients was 12% (range 4-21%) and the main causes of anaemia were malaria, sickle cell haemoglobinopathy and septi caemia. The mortality rates for patients in whom heart failure complicated anaemia, bronchopneumonia and primary cardiac disorders were 25%, 36% and 47%, respectively. These figures are significantly higher than the 8% overall mortality rate for all children admitted into the Emergency Room during the study period. Thus, if such gravely ill children are to be sal vaged, both the primary diseases and their complications must be identified promptly and treated effectively.