Frequency of cardiac complications in Beta-thalassemia patients at National Institute of Child Health, Karachi, Pakistan

Abstract

Objective: To determine the frequency of cardiac complications in beta-thalassemia children. Study Design: Cross-sectional study. Setting: Department of Pediatric Medicine, National Institute of Child Health (NICH), Karachi, Pakistan. Period: March 2024 to August 2024. Methods: Children of either gender, aged 5 to 15 years and diagnosed cases of beta-thalassemia major were analyzed. At the time of enrollment, the demographic details of each child, such as gender and age were documented. Information related to the child's disease duration, transfusion frequency, and type of therapy, were recorded. Chest X-rays (CXR), electrocardiograms (ECG), and echocardiograms, were performed at NICVD and evaluated by an experienced cardiologist to determine the frequency of cardiac complications. Results: In a total of 188 children, 102 (54.3%) were male. The mean age was 9.5±2.9 years. The mean disease duration, and blood transfusions over lifetime were 68.5±24.6 months, and 150.4±42.7, respectively. There were 152 (80.9%) patients who were undergoing both transfusion and chelation therapy. Cardiac complications were prevalent in 103 (54.8%) children. Cardiomegaly was the most common cardiac abnormality, found in 96 (51.1%), while congestive heart failure was identified in 33 (17.6%) children. Older age group (p=0.028), and increasing disease duration (p0.004) were noted to have significant association with cardiac complications. Conclusion: The prevalence of cardiac complications, particularly cardiomegaly and heart failure, were very high in children with beta-thalassemia major. Prolonged disease duration and older age are significant risk factors, highlighting the importance of early diagnosis and aggressive management of iron overload.