Key result
Suspected heart failure drives ~44% of echocardiography referrals, most frequently revealing hypertensive heart disease.
Why the study?
To provide insight into the spectrum of cardiovascular diseases prevalent in contemporary northern Ghana by reviewing patients referred for echocardiography at a tertiary facility.
Cross-Sectional (n=1,111)
No
In Northern Ghana, heart failure is the most common indication for echocardiography, predominantly driven by hypertensive heart disease, though the low diagnostic confirmation rate highlights a need for appropriate use criteria.
Background Transthoracic echocardiography (TTE) is a highly versatile and relatively affordable initial cardiac imaging modality that is useful for diagnosing cardiac structural and functional abnormalities. We present data of patients referred to a tertiary facility in northern Ghana for echocardiography. These findings provide insight into the spectrum of cardiovascular diseases prevalent in contemporary northern Ghana. Methods This was a cross-sectional retrospective review of data of patients presenting to the Cardiology Unit of the Tamale Teaching Hospital for TTE between October 2022 and September 2024. Results A total of 1,111 echocardiographic studies were performed, comprising 937 (84.3%) adult studies. Over half of adult patients referred for an echocardiogram were female (516 (55.1%)); however, male patients were significantly older (56±17 years versus 53±19 years, p=0.007). The commonest indication for adult echocardiograms was a clinical suspicion of heart failure (HF) (412 (44%)). Among adult patients referred with a clinical suspicion of HF, hypertensive heart disease (HHD) was the commonest etiology (109 (26.5%)). HHD was also the commonest primary echocardiographic diagnosis amongst the adult population (238 (25.4%)). Echocardiography confirmed the clinical suspicion of the referring clinician in 332 (35.4%) of adult patients. Conclusion The commonest indication for adult echocardiography was HF with HHD being the commonest underlying etiology. Our findings align with national trends of HHD being the most common cause of HF among Ghanaian adults. Notably, a significant proportion of echocardiograms were normal despite clinical suspicion of HF. A generally low diagnostic yield/confirmation rate underscores the need for training and local guidelines on appropriate use criteria for echocardiography. Further studies are needed to explore these findings on a national scale.
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Ahadzi et al. (2025) conducted a cross-sectional in Suspected cardiovascular disease (n=1,111). Transthoracic echocardiography was evaluated on Primary echocardiographic diagnosis and indication for echocardiography. Among 937 adults referred for echocardiography, the most common indication was suspected heart failure (44.0%), and hypertensive heart disease was the most frequent primary diagnosis (25.4%).
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