The Heart of Africa Clinical Profile of an Evolving Burden of Heart Disease in Africa

• Designed to provide anyone with an interest in heart disease in Africa with an immediate sense of how the area is progressing from a clinical to research perspective in responding to this evolving epidemic
• Presents salient research uncovering the evolving burden of communicable and non-communicable forms of heart disease,
• Includes content on maternal heart disease, infant and childhood heart disease, risk and prevention, heart failure and other common forms of heart disease in rural and urban communities in Africa.

Simon Stewart PhD, NFESC, FAHA, FCSANZ
Mary MacKillop Institute for Health Research,
Australian Catholic University,
Melbourne, Victoria, Australia 

Karen Sliwa MD, PhD, FESC, FACC
Hatter Institute for Cardiovascular Research in Africa, Department of Medicine,
Faculty of Health Sciences, University of Cape Town, South Africa;
Soweto Cardiovascular Research Group, Faculty of Health Sciences, University of the Witwatersrand.

Ana Mocumbi MD, PhD, FESC
Instituto Nacional de Saude Ministerio da Saude Doencas Cronicas
Nao Transmissiveis Instituto
Maputo, Mocambique

Albertino Damasceno MD, PhD
Departamento de Medicina/Faculdade de Medicina
Universidade Eduardo Mondlane
Maputo, Moçambique 

Mpiko Ntsekhe MD, PhD, FACC
Division of Cardiology
Department of Medicine,
University of Cape Town,
Groote Schuur Hospital
Cape Town, South Africa

List of contributors vii

Foreword x

Preface xii

Acknowledgments xiv

Sub�-Saharan Africa and The Heart of Africa: A brief introduction 1

Section 1: Maternal heart health
Karen Sliwa

1 Maternal heart health 9
Karen Sliwa, John Anthony, and Denise Hilfiker-Kleiner

References 27

Section 2: Infant and childhood heart disease
Ana Mocumbi

2 Congenital heart disease 35
Ana Mocumbi, Tantchou Tchoumi Jacques Cabral, John Musuku, and Serigne A. Ba

3 Acquired heart disease 44
Ana Mocumbi, Liesl Zühlke, and Peter Zilla

References 63

Section 3: Spectrum of cardiovascular risk and heart disease in sub-Saharan Africa
Simon Stewart

4 Cardiovascular risk in urban and rural African settings 73
Kemi Tibazarwa, Karen Sliwa, Melinda Jane Carrington, Okechukwu Samuel Ogah, and Simon Stewart

5 The African INTERHEART study 89
Krisela Steyn and Karen Sliwa

6 The spectrum of heart disease in urban Africans: The Heart of Soweto Study 96
Melinda Jane Carrington, Karen Sliwa, and Simon Stewart

References 113

Section 4: Infectious heart disease
Mpiko Ntsekhe

7 Rheumatic heart disease 121
Simon Stewart, Melinda Jane Carrington, and Karen Sliwa

8 Pericardial disease 136
Mpiko Ntsekhe

9 Human immunodeficiency virus–related heart disease 145
Friedrich Thienemann, Melinda Jane Carrington, Karen Sliwa, Mpiko Ntsekhe, and Simon Stewart

References 152

Section 5: Noncommunicable disease
Albertino Damasceno

10 Acute coronary syndrome in the African context 159
Anthony Becker

11 Stroke in the African context 176
Albertino Damasceno

References 183

Section 6: Heart failure
Simon Stewart

12 Acute heart failure 193
Mahmoud Sani, Dike Bevis Ojji, Anastase Dzudie, and Okechukwu Samuel Ogah

13 Hypertensive heart failure 212
Dike Bevis Ojji, Mahmoud Sani, Anastase Dzudie, and Okechukwu Samuel Ogah

14 Chronic heart failure 226
Okechukwu Samuel Ogah, Anastase Dzudie, Dike Bevis Ojji, and Mahmoud Sani

15 Pulmonary hypertension and right heart failure 237
Anastase Dzudie, Friedrich Thienemann, Okechukwu Samuel Ogah, Dike Bevis Ojji, and Mahmoud Sani

References 245

Abbreviations 254

Index 256

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