Introduction There is ample evidence linking high blood cholesterol levels to Cardiovascular Disease (CVD) events, including myocardial infarction, strokes, and peripheral vascular disease. On the other hand, there is also evidence for significant reduction in morbidity and mortality from CVDs by reducing blood cholesterol levels in those at risk (primary prevention) and those who have … Read more

Dizziness and blackouts

Introduction Dizziness is a nonspecific term that refers to abnormal sensation of body orientation or position in space. These include feeling of unsteadiness, light-headedness and vertigo. Patients often find these sensations difficult to describe. Dizziness is almost always associated with other symptoms, therefore a careful history and focused physical examination should be performed in all … Read more

Cardiac arrhythmias

Introduction Arrhythmias are disorders of cardiac rate, rhythm and conduction. They can be classified as bradyarrhythmias (heart rate < 60 per minute)¬†and tachyarrhythmias (heart rate > 100 per minute). Bradyarrhythmias include sinus bradycardia, sinus pauses and atrioventricular blocks. The tachyarrhythmias can further be classified into supraventricular and ventricular arrhythmias, based on their site of origin. … Read more

Hypertensive emergencies

Introduction A hypertensive crisis is a severe and potentially life threatening increase in blood pressures (BP) which may result in an acute stroke, subarachnoid haemorrhage, seizures (hypertensive encephalopathy), heart attack, acute dissection of aorta, heart failure, renal damage or eclampsia (during pregnancy). The underlying cause may be primary hypertension; however, secondary causes of hypertension must … Read more

Hypertension in children and adolescents

Introduction Hypertension in children is defined as an average systolic and/or diastolic blood pressure that is 2 95th percentile for gender, age, and height on 3 or more separate occasions taken in the right arm (in view of possibility of coarctation of aorta). An appropriate cuff size that covers two thirds () of the length … Read more

Hypercyanotic attack

Introduction This is a life threatening paediatric cardiac emergency. It usually occurs in infants with a peak incidence between 4 and 6 months. A severe episode may lead to limpness, seizures, cerebrovascular accident or even death. Spells may be brief (1-2 minutes) and self-correct or may progress to a severe, life-threatening episode. Prompt recognition by … Read more

Rheumatic Heart Disease

Introduction Rheumatic heart disease is a complication of rheumatic fever – a common cause of cardiac failure in Nigeria. In Africa, it manifests later compared to Caucasians. The mitral valve is most affected, followed by the aortic, then the tricuspid. The lesions can occur in various combinations of regurgitation and stenosis Clinical features Exertional dyspnoea … Read more

Rheumatic Fever

Introduction Rheumatic Fever is a result of abnormal reaction of antibodies developed against antigens of group A B-haemolytic streptococcus. Infection is usually of the throat; occasionally the skin in a sensitized individual. Antigen-Antibody complex damages the heart (endocardium, myocardium and pericardium). The commonest streptococcal strains in Africa are C and G Clinical features Duckett-Jones’ diagnostic … Read more

Pulmonary Oedema

Introduction Pulmonary Oedema occurs when there is congestion of the lungs with fluid, usually in a scenario of left-sided cardiac failure. This results in stiffness of the lungs and flooding of the alveoli, with difficulty in breathing. Pulmonary Oedema may also follow inflammatory processes. It may be acute or chronic Clinical features Difficulty in breathing, … Read more


Introduction Pericarditis is an inflammation of the pericardium, which may arise from viral, bacterial, fungal or protozoal infections. Other causes of pericarditis include: metabolic, malignancy, connective tissue disease, radiation, trauma etc. Pericarditis may be acute or chronic Clinical features Acute pericarditis: Chest pain Retrosternal Sharp Radiating to the left shoulder Made worse by breathing or … Read more