Cardiology

High blood pressure is the most consequential undiagnosed condition in Nigeria. It produces almost no symptoms for years, and by the time it announces itself it has often already damaged the heart, the kidneys, the eyes or the brain. A very large share of the strokes seen in Lagos hospitals are the end of a hypertension story that nobody was tracking.

Our cardiology service exists to interrupt that story earlier. We assess and manage hypertension, heart failure, rhythm disturbances, chest pain and overall cardiovascular risk, both for outpatients on long term treatment and for inpatients who arrive acutely unwell.

Blood pressure, properly measured

A single high reading taken after a fight with Lagos traffic is not a diagnosis. Blood pressure is confirmed with repeated measurements on separate occasions, using a correctly sized cuff, on a rested patient, and often supported by home readings or ambulatory monitoring.

Once confirmed, the workup looks for damage already done and for treatable underlying causes. That means kidney function and urinalysis, electrolytes, fasting glucose and lipid profile, an electrocardiogram, an echocardiogram where indicated, and a fundoscopic look at the retina.

Treatment is a combination of medication and the things people would rather not hear about, principally salt intake, weight, alcohol and physical activity. Nigerian diets carry a great deal of hidden sodium in seasoning cubes, dried fish and processed staples, and reducing that alone changes numbers meaningfully.

Heart failure and chest pain

Heart failure presents as breathlessness on exertion or lying flat, swelling of the legs, fatigue and reduced exercise tolerance. It is not a single disease but the end result of several, most commonly long standing hypertension in this population, and it needs an echocardiogram to characterise properly rather than a clinical guess.

Chest pain is assessed urgently. We take a history, perform an electrocardiogram, and where the picture suggests an acute coronary syndrome we stabilise, initiate treatment and coordinate transfer to a facility with catheterisation capability without delay. Being honest about the boundary of what we do here is part of doing it safely.

Cardiovascular risk assessment

For anyone over forty, or younger with a family history of early heart disease, a structured risk assessment is worth more than any single test. We combine blood pressure, lipid profile, glucose or HbA1c, body measurements, smoking status, family history and an electrocardiogram into a picture of your actual risk over the coming decade, and then a plan proportionate to it.