Causes and clinical characteristics of chronic cor-pulmonale in Ethiopia.

OBJECTIVE To determine the clinical characteristics and underlying causes of chronic cor-pulmonale in Ethiopian patients. DESIGN A hospital based cross-sectional study. SETTING Tikur Anbessa Hospital, a large referral hospital in Addis Ababa, Ethiopia. SUBJECTS Fourty two consecutive patients referred to the chest clinic of Tikur Anbessa Hospital, Addis Ababa, Ethiopia. RESULTS Bronchial asthma (36%), chronic fibrocavitary tuberculosis (31%) and chronic bronchitis/emphysema (33%) were the most frequent underlying causes and occurred either singly or in combination in 36(86%) of patients. Interstitial lung disease occurred in five (11.9%) patients. Right-sided heart failure and cyanosis were the most common clinical presentations. Secondary polycythemia was noted in 32 of 40 patients (80%). The role of pulmonary vascular diseases including pulmonary schistosomiasis as a cause of pulmonary heart disease could not be ascertained but appeared to be insignificant. CONCLUSION Chronic persistent asthma is a frequent underlying cause of chronic obstructive pulmonary disease and chronic cor-pulmonale compared to smoking related chronic bronchitis/emphysema in Ethiopia. The preventive strategy of chronic cor-pulmonale includes optimal treatment of bronchial asthma, early diagnosis and effective treatment of tuberculosis and health education to avoid cigarette smoking.