Heart failure in sub-Saharan Africa: A clinical approach

Abstract

Despite medical advances, heart failure (HF) remains a global health problem and sub-Saharan Africa (SSA) is no exception, with
decompensated HF being the most common primary diagnosis for patients admitted to hospital with heart disease. In SSA the in-hospital
mortality rate of decompensated HF is up to 8.3%. HF is a clinical syndrome that is caused by a diverse group of aetiologies, each requiring
unique management strategies, highlighting the need for diagnostic certainty and a broad understanding of the complex pathophysiology of
this condition. While there are a number of advanced medical, device and surgical interventions being tailored for HF internationally, the
fundamental basic principles of HF management, such as patient education, effective management of congestion and initiation of diseasemodifying
medical therapies, remain a challenge on our continent. This review addresses both the epidemiology of HF in SSA and principles
of management that focus specifically on symptom relief, prevention of hospitalisation and improving survival in this population.