Diagnostic Profile of Cardiovascular diseases among patients presented in cardiology outpatient department of a tertiary care centre

Abstract

Introduction: Cardiovascular diseases (CVDs) are the leading cause of death across the globe. Thirty two percent of all global deaths in 2019 were attributed to CVDs, 85% of which were due to heart attack and stroke; over three quarters of CVD deaths take place in low- and middle-income countries. This study was based on the OPD visits to cardiology department in a central multidisciplinary hospital the results of which would be a gross reflection of what exits in reality at the community level.

Methods: It is an OPD-based retrospective observational study. The patients examined in cardiology OPD were enrolled in the study. Demographic profiles of the patients including age, sex and place of residence, diagnosis, co-morbidities, if any and associated CVD risk factors were taken from the medical record maintained in OPD. Ethical clearance was taken from the Institutional Research Board (IRB), National Academy of Medical Sciences, Bir Hospital. Sample size was calculated from the population proportion formula, which came out to be 384. IBM Statistical Package for the Social Sciences (SPSS) version 23 was used for data analysis.

Results: A total of 2445 patients were enrolled in the study. Among them 51.5% were female and 48.5% were male. The mean age of the study population was 53.72 +15.69 years. Most of the patients were from Kathmandu valley [76.28%] Maximum number of patients were middle-aged (45 – 64 years) in both genders. Ischemic heart disease (31%), Arrythmia and conduction defects(24%), heart failure (23%) and rheumatic heart disease (4%) were the first four common diseases in CVD spectrum. Hypertension was the most common CVD risk factor (52.3% ) followed by diabetes (8.7%). A significant proportion of patients presented with non-cardiac causes (25.73%). Psychiatric illness, mostly in the form of anxiety and depression, was the most common co-morbidity (6.29%). COPD was the second most common co-morbidity (3.5%) and was predominant in the elderly patients. Renal diseases ranked third in the hierarchy. Orthopedic cases were commonly seen in adult population (5.1%) followed by the elderly (1.8%). Multiple co-morbidities were common in the elderly patients, which were present in 4.6% of their total population. Ischemic stroke was also higher in the elderly (2.4%). Hypothyroidism was far more common among adult females.

Conclusion: Ischemic heart disease, arrythmia and conduction defects, heart failure and rheumatic heart disease were the first four common diseases in CVD spectrum. Hypertension was the most common CVD risk factor in our patients. Psychiatric illness in the form of anxiety and depression, COPD, renal diseases and orthopedic issues were the first four common co-morbidities.