Frequency of Heart Failure in Patients with Beta Thalassemia Major

Abstract

Background: Estimated prevalence of beta thalassemia is 3-8% in Pakistan. Over the past three decades, regular blood transfusions have significantly increased the survival of these patients. There has been an increase in the frequency of complications, mainly caused by iron overload. The aim of this study was to determine the frequency of heart failure in patients with beta thalassemia major in this region. Material and Methods: It was a descriptive audit of ward record, carried out in the Department of Paediatrics, District Headquarter Teaching Hospital, D.I.Khan, Pakistan, from January 2004 to December 2005. Case records of all beta thalassemia major patients admitted during this period were analyzed for heart failure. Clinical data recorded was age, sex and cardiac status of patients. Investigations including ECG, chest x-ray and echocardiography were evaluated. Results: Two hundred and twelve patients of beta thalassemia were admitted during the study period. Clinical congestive cardiac failure was observed in 33 (15.6%) patients with the age range of 8-21 years. Fifty four patients (25.5%) had cardiomegaly on chest x-ray but were not having clinical heart failure. Age range of these patients was 5-12 years. As a whole heart failure and cardiomegaly on chest x-ray was observed in 87 (41.1%) patients. All these patients were above the age of 5 years. Conclusion: Heart failure is not uncommon in patients with beta thalassemia major in our setup. Regular transfusions and chelation therapy are recommended to reduce this complication.