Clinical Profile of Heart Failure in Hospitalised Women of Reproductive Age Group

Abstract Background: Heart failure (HF) in reproductive-age women is a complex clinical condition, often considered distinct from HF in older women. This research was conducted to study the risk factors, aetiology and clinical presentation of HF in the reproductive age group, determine the type of HF by echocardiography and assess the in-hospital outcomes. Materials and Methods: This was a prospective observational study conducted over 18 months involving 112 female patients aged 15–49 years with symptomatic HF (Stage C or D as per the Framingham criteria), admitted to the medicine emergency and wards and the cardiac care unit. Pregnant women and those aged <15 or ≥50 were excluded. Results: Of the 112 patients, 67% were aged 40–49 years. Almost 80% belonged to the lower-middle socioeconomic class. At presentation, dyspnoea was universal, 85% had orthopnoea, fatigue in 75% and ankle oedema in 33%. About 70.5% patients had New York Heart Association (NYHA) Class IV. Hypertension, obesity and diabetes were the most frequent risk factors. Dilated cardiomyopathy (19.6%) and ischemic heart disease (17.9%) were the commonest causes of HF, with HF with preserved ejection fraction type in 43.8% of patients. A total of 58% of patients improved to NYHA Class II at discharge. There was a significant relationship between the cause of HF and a patient’s age, chest pain, hypertension and diabetes, cardiac biomarkers and ejection fraction. Conclusions: This study demonstrates the characteristics of HF in younger women, highlighting that traditional lifestyle-related cardiac diseases and cardio-metabolic risk factors are also relevant in this group, underscoring the need for early screening.