Echocardiography in helping to determine the causes of pericardial effusion in the Sudanese patients

Pericardial disease is not uncommon in Sudan and the etiology may impose a diagnostic problem. The aim of this study is to determine the etiology of isolated pericardial effusion and to assess the usefulness of the echocardiographic features of the effusion in helping to determine the etiology.This is an observational cross-sectional prospective study done from Jan. 2002 to Aug. 2003. Fifty one patients were collected from four centers in Khartoum State. Chest X-ray, Echocardiogram and ECG were done for all patients. Pericardiocentesis was done for 35 patients [68.6%]. Specific investigations for the etiological diagnosis were done when appropriate. Male to female ratio was 1.3:1.The age ranged between 4 and 80 years with 68% of patients in the age group 11-40 years. Forty one Patients [82%] were referred with a correct diagnosis of pericardial effusion. The etiology was evident clinically or by specific investigation in 31 patients [61%] and 20 patients [39%] needed pericardiocentesis. The common etiologies were tuberculosis, malignancies, rheumatological, idiopathic and bacterial infection consecutively. The result showed useful echo features to differentiate between tuberculous, occult malignancy and idiopathic etiologies. Thickened Effusion, fibrin strands and shaggy pericardium are suggestive of tuberculosis while thickened Effusion without fibrin strands or shaggy pericardium makes malignancy a competitive diagnosis and the thin appearance of the effusion with shaggy pericardium and no fibrin strands goes more with idiopathic effusion while the features of massive effusion, tamponade or the hemorrhagic appearance of the fluid although common in these three etiologies has no much differential value

Pattern and severity of rheumatic valvular lesions in children in Khartoum, Sudan

We determined the pattern and severity of valvular involvement in 100 Sudanese patients with rheumatic heart disease [RHD] in 2 centres in Khartoum in 2003. All the patients underwent history taking, physical examination and Doppler echocardiography. The commonest lesions were mitral regurgitation [84%] and aortic regurgitation [40%]. Mitral stenosis alone was uncommon [9%] which could be due to a low detection rate related to the slow stenotic process and the subtle early signs. This, together with the inconsistent history of rheumatic fever, may lead to an underestimate of the prevalence of RHD. There was a strong correlation between severity of the lesion and irregular prophylaxis [P < 0.001]

Coronary anomalies in Sudanese patients: angiographic study and brief review

Coronary anomalies are not rare [about 1'% of the general population] and may be associated with sudden dealth and ischemia and may cause difficulties in coronary interventions and errors in bypass surgery. The aim of this study is to demonstrate their incidence in the Sudanese patients and give a review on their classifications and clinical relevance- A retrospective study of 270 patients who had coronary angiography at Ahmed Gasim cardiac center from April, 2004 to August, 2005 Our study showed a rather higher rate of coronary anomalies [3%] but the pattern was not greatly different from the figures in the literature. Anomalies of origin were the most common [which may give difficulties in coronary interventions]. Potentially morbid anomaly with either the left anterior Ascending artery [LAD] or the left main coronary artery [LMCA] originating from the right coronary sinus was seen in 3 patients [1, 1%]. This study demonstrated that coronary anomalies are not rare in our patients and potentially serious anomaly may exist