Heart disease in East Timor: cross‐sectional analysis of 474 patients attending Timor‐Leste's first cardiology service

BACKGROUND: East Timor is a developing country and is a close neighbour of Australia. The prevalence of cardiac disease is unknown. AIMS: To describe the prevalence and patterns of cardiac disease in patients attending the first cardiology service of Timor-Leste. METHODS: A cross-sectional retrospective analysis was performed of demographic and clinical data of 474 unique patients referred to outpatient cardiology clinics conducted in East Timor from 2003 to 2016. RESULTS: Mean age was 29.9 ± 18.5 years, with females significantly younger than males (28.8 ± 16.9 vs 32.3 ± 20.6 years). Congenital cardiac disease patients were the youngest (15.5 ± 13.9 years) and cardiomyopathy patients the oldest (46.7 ± 17.8 years). Of patients with rheumatic heart disease, the majority had mitral stenosis (59.4%) and multi-valvular involvement (61.6%). Of note, 28.3% of patients with rheumatic heart disease presented with severe mitral stenosis. Amongst congenital heart disease patients, the most common diagnosis was atrial or ventricular septal defects (61% combined). A total of 19.2% of patients either required immediate referral for intervention or palliation for their cardiac disease. Patients referred to Australia for treatment were significantly younger (19.7 ± 11.7 years) than all other outcome groups. CONCLUSION: Amongst young East Timorese, rheumatic heart disease and unrepaired congenital cardiac defects impose a significant burden. One-fifth of patients present to clinics with severe disease requiring urgent referral for surgery or palliation.