Cardiac pacemaker insertion in the South-South Region of Nigeria: Prospects and challenges

With the global increase in the prevalence of cardiovascular diseases, economically less developed countries are faced with the double jeopardy of contending with existing communicable diseases and the new epidemic of non-communicable diseases. The South-South region of Nigeria is a cosmopolitan area with a high prevalence of hypertension and its complications. The disease trends in the region have resulted in increasing demand for invasive cardiac procedures which are largely unavailable in this subregion. This review examines the prospects and possible challenges of interventional cardiology care in South-South Nigeria, using cardiac pacemaker implantation as a surrogate

Congestive cardiac failure in a patient with systemic sclerosis: Case report and literature review

Background: Systemic sclerosis and other connective tissue diseases are thought to be rare in Nigerians and are not common causes of heart failure compared to hypertensive heart disease. The presence of cardiac involvement in a patient with systemic sclerosis generally portends poor outcome. We therefore present a report of congestive cardiac failure in a patient with systemic sclerosis.Methods: The case records of a patient with systemic sclerosis and congestive cardiac failure and a review of the literature utilizing Medline, PubMed and google search engines was utilized.Result: A 68 year old female with ACR criteria for the diagnosis of SSe presented in CCF. Cardiac evaluation revealed findings suggestive of primary cardiac disease of SSe. The presence of CCF in patients with SSe is a poor prognostic marker andcause of mortality and morbidity,Conclusion: Early detection of cardiovascular manifestations should be a priority insystemic sclerosis. To the best of our knowledge, CCF due to SSe has not been reported in Nigerians.Keywords: Systemic sclerosis; Primary Cardiac Disease; Heart failure; Nigerian

A 45-year old man with recurrent syncope: an unusual presentation of coronary artery disease

A 45-year old normotensive, euglycaemic, non-smoker was referred from a peripheral hospital to the Cardiology unit of the University College Hospital, Nigeria for evaluation of recurrent exercise induced syncope. Initial 12-lead electrocardiogram (ECG), 24-hr ambulatory ECG, transthoracic echocardiogram and electroencephalogram (EEG) were normal. A repeat episode of syncope warranted further investigation. Immediate post syncope ECG showed deeply inverted symmetrical T waves in the anterior leads. He underwent coronary angiogram which revealed distal left main disease and 70-80% stenosis of the proximal Left Anterior Descending Artery (LAD). The Circumflex artery was non dominant with normal Right Coronary artery. He subsequently had Percutaneous Transluminal Coronary Angioplasty (PTCA) of the LAD. Post-revascularisation course has been satisfactory with no recurrence of syncope. In view of the rising trend of cardiac death in the country, there is the need for high index of suspicion in making diagnosis of coronary artery disease in patients with syncope.Pan African Medical Journal 2013; 14: 7

Factors Associated with Medication Nonadherence among Hypertensives in Ghana and Nigeria

Background. Blood pressure (BP) control is poor among hypertensives in many parts of sub-Saharan Africa. A potentially modifiable factor for control of BP is medication nonadherence (MNA); our study therefore aimed to determine factors associated with MNA among hypertensives in Ghana and Nigeria. Methodology. We conducted a multicenter cross-sectional study. Patients were recruited from Korle-Bu Hospital (n=120), Ghana; and University of Port Harcourt Teaching Hospital, (n=73) Apapa General Hospital Lagos (n=79) and University College Hospital Ibadan (n=85), Nigeria. Results. 357 hypertensive patients (42.6% males) participated. MNA was found in 66.7%. Adherence showed correlation with depression (r=-0.208, P<0.001), concern about medications (r=-0.0347, P=0.002), and knowledge of hypertension (r=0.14, P=0.006). MNA was associated with formal education (P=0.001) and use of herbal preparation (P=0.014). MNA was found in 61.7% of uninsured participants versus 73.1% of insured participants (P=0.032). Poor BP control was observed in 69.7% and there was significant association between MNA and poor BP control (P=0.006). Conclusion. MNA is high among hypertensives in Ghana and Nigeria and is associated with depression, concern about hypertensive medications, formal education, and use of herbal preparations. The negative association between health insurance and MNA suggests interplay of other factors and needs further investigation