Significance of 2D Echocardiography in Thalassemia Major/Intermedia Patients at a Tertiary Care Centre: A Cross-Sectional Observational Study
Dakavaram Hema Manvi, Manasa R, Padmajarani V, Manohar Badur, Rajashaker Venkatappa
Author(s)3Assistant Professor, Department of Paediatrics, SV Medical College, Tirupati, India, 4Professor, Department of Paediatrics, S.V. Medical College Tirupati, India, 5Assistant Professor of Paediatrics, SV medical College, Tirupati, India.
Abstract
Background: Beta-thalassemia major is the commonest transfusion-dependent hemoglobinopathy in South Asia. Cardiac iron overload is the leading cause of mortality, yet early non-invasive cardiac surveillance remains inconsistently practiced in resource-limited settings. The objective is to evaluate the role of 2D echocardiography in detecting cardiovascular complications in pediatric thalassemia patients and correlate findings with serum ferritin. Material and Methods: Hospital-based cross-sectional observational study of 57 transfusion-dependent beta-thalassemia patients aged 1–18 years at SVRRGGH Tirupati (June 2023–October 2024). All underwent 12-lead ECG, 2D echocardiography (48 hours post-transfusion), and pre-transfusion serum ferritin estimation. Results: 56% male; 98.2% thalassemia major. Echocardiographic abnormalities in 33% of patients; PAH in 5.26%, dilated LA/LV in 7.01%, tricuspid regurgitation in 22.8%. Mean EF 62.91%. Ferritin ≥1000 ng/mL in 89.47%. ECG abnormal in 22.8%. Echocardiography: sensitivity 72.22%, specificity 100%, diagnostic accuracy 91.23% vs ECG. Conclusion: 2D echocardiography is a sensitive, specific, accessible tool for early cardiac surveillance in thalassemia. Routine echocardiographic screening should be integrated into standard management protocols. Keywords: Thalassemia major; 2D echocardiography; iron overload; pulmonary hypertension; serum ferritin; pediatric cardiology.