THE IMPACT OF ECHOCARDIOGRAPHY IN THE DIAGNOSIS OF HYPERTROPHIC CARDIOMYOPATHY

The results of 1240 consecutive abnormal echocardiography (ECHO) studies performed between January 1984 and June 1988 were reviewed in order to determine the impact made by the availability of ECHO in the diagnosis and possibly understanding of hypertrophic cardiomyopathy (HCM) in Ethiopia where the condition has not yet been reported. Cardiomyopathies in general were seen in 154 patients; of whom 53 (34.4%) were found to have HCM. The male to female ratio was 3.1:1 (40 males and 13 females) and the mean age was 27.9 yrs, (range 6-80). Asymmetric septal hypertrophy involved the basal one-third of the ventricular septum in 11 (20.8%) patients, basal two-third in 15 (28.3%) and in the majority, 27 (50.9%), it involved the whole septum. Substantial degree of septal hypertrophy (greater than 30 mm), anterolateral wall involvement and severe systolic anterior motion of the mitral valve were seen most commonly among patients with whole septum hypertrophy. These were observed less frequently among patients with basal two-third and basal one-third involvement. These associations, furthermore, appear to indicate presence of obstructive HCM. It is concluded that HCM is not uncommon in Ethiopia. In a country where there are limited diagnostic facilities, ECHO could be used for the classification of HCM and for monitoring patients' response to medical treatment. A prospective study which correlates ECHO clinical finding is needed.