An audit of the establishment of a cardiac magnetic resonance imaging service in a public tertiary hospital setting in the Western Cape Province of South Africa

Pan Afr Med J. 2024 Sep 12:49:15. doi: 10.11604/pamj.2024.49.15.44617. eCollection 2024.

Abstract

Introduction: cardiovascular magnetic resonance imaging is considered the standard of care for many clinical cardiovascular applications. Magnetic resonance imaging is a scarce resource in sub-Saharan Africa, with a paucity of cardiac magnetic resonance imaging clinical services and research. The aim of this audit was to review the cardiac magnetic resonance imaging service provided at a public tertiary hospital in Cape Town, Western Cape Province, South Africa.

Methods: a retrospective, descriptive audit via quantitative record review of Tygerberg Hospital´s cardiovascular magnetic resonance imaging service was conducted from the inception thereof on 1st April 2015 up to 31st October 2022.

Results: a total of 1,403 cardiovascular magnetic resonance imaging scans met the inclusion criteria. The mean age of the study population was 43 years, and 52% were female. The most common patient comorbidities were modifiable cardiovascular risk factors, including hypertension (22%; n=306), cigarette smoking (9.6%; n=134), diabetes mellitus type II (6.7%; n=94) and dyslipidaemia (4.4%; n=62). Sixty-three percent (n=888) of scans were performed after hours. In 93% of scans, intravenous gadolinium-based contrast agents were administered. Nonischaemic cardiomyopathy dominated the indications (56.7%; n=976) and final diagnosis (42%; n=589). The most common incidental extracardiac finding was hilar or mediastinal lymphadenopathy (6%; n=82).

Conclusion: the recently established, functional cardiovascular magnetic resonance imaging service at Tygerberg Hospital serves a unique patient population with a comparatively differently distributed cardiac disease spectrum, contributing to research diversity.

Keywords: Africa South of the Sahara; Heart; cardiovascular diseases; clinical audit; magnetic resonance imaging.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cardiovascular Diseases* / diagnosis
  • Cardiovascular Diseases* / diagnostic imaging
  • Cardiovascular Diseases* / epidemiology
  • Child
  • Child, Preschool
  • Contrast Media / administration & dosage
  • Female
  • Heart Diseases / diagnosis
  • Heart Diseases / diagnostic imaging
  • Heart Diseases / epidemiology
  • Hospitals, Public
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Medical Audit
  • Middle Aged
  • Retrospective Studies
  • South Africa
  • Tertiary Care Centers*
  • Young Adult

Substances

  • Contrast Media