Pulmonary tuberculosis is an endemic pathology in Gabon. Long delays in diagnosis and difficulties in management can be the cause of broncho-pulmonary and extra-pulmonary sequelae.

To describe the epidemiological, diagnostic and evolutionary aspects of isolated chronic right heart failure due to tuberculosis sequelae.

This was a retrospective descriptive study performed by analyzing the files of patients hospitalized for isolated chronic right heart failure in the cardiology department of the Libreville University Hospital Center from January 2012 to December 2020.

A total of 222 patients were studied. Tuberculosis sequelae were retained as the etiology of chronic isolated right heart failure in 10.8% (n=24). The median age of the patients was 37 years (range 5–250). A history of tuberculosis was found in all patients with a median anteriority of 2.8 years (range 1–10). Multidrug-resistant tuberculosis had been reported in one case. Three (12.5%) patients had constrictive pericarditis with large calcifications. The diagnosis of chronic cor pulmonale on broncho-pulmonary lesions secondary to tuberculosis was retained in 21 (87.5%) patients. Lung lesions objectived were emphysema (n=4, 19.0%) (Fig. 1), severe sclero-retractile damage (n=15, 71.4) and pulmonary fibrosis (n=2, 9.5%). The echocardiographic lesions were severe with a median end diastolic diameter of the right ventricle of 43mm (range 32–54mm), a tricuspid annular plane systolic excursion less than or equal to 12mm in 7 cases and a systolic arterial pulmonary pressure greater than 75mmHg in 5 cases. Three patients were oxygen dependent. Four patients (16.7%) died during hospitalization, three of them in refractory right heart failure with multiple organ failure and one with respiratory distress. The median length of stay was 18 days (range 5–250).

Tuberculosis sequelae is a common cause of chronic right heart failure in our regions. Early management of this curable infectious disease is a priority. The collaboration of cardiologists with the National Program for this infection is a necessity.