Purpose: To describe the epidemiological, clinical and management characteristics of acute coronary syndromes (ACS) in Thies, Senegal. Methods: This was a prospective study that included consecutively from Octobe...Purpose: To describe the epidemiological, clinical and management characteristics of acute coronary syndromes (ACS) in Thies, Senegal. Methods: This was a prospective study that included consecutively from October 1<sup>st</sup>, 2018 to March 03<sup>rd</sup>, 2019, patients aged 18 years or older admitted for an ACS at the DIABCARMET department of the Saint Jean de Dieu Hospital in Thies. Results: Of the 516 patients admitted, 29 had ACS, the prevalence was 5.62%. The average age of the patients was 64.2 ± 11.6 years. Nineteen patients (65.5%) were male and 10 (34.5%) were female, the sex ratio was 1.91. The number of direct admissions was 18 (62%) versus 11 patients (38%) referred. The mode of transport was a private vehicle in 19 patients (65.5%), an ambulance in 7 patients (24.1%) and public transport in 3 patients (10.3%). STEMI (ST segment elevation myocardial infarction) was the most common presentation observed in 19 patients (65.5%). Fifteen patients (51.7%) were admitted before the 12<sup>th</sup> hour. Of the 19 patients with STEMI, 11 (57.9%) had arrived in hospital before the 12<sup>th</sup> hour and 10 patients had streptokinase thrombolysis. No patients received primary PCI. Ten patients (34.5%) had heart failure and five patients (17.2%) died during hospitalization. Conclusion: Delayed consultation and high mortality characterize ACS in Thies. Prevention must be the rule.展开更多
Introduction: The objective of this work was to describe the epidemiological, etiological, clinical and therapeutic aspects of atrial fibrillation (AF) in Thies, Senegal. Materials and Methods: This was a retrospectiv...Introduction: The objective of this work was to describe the epidemiological, etiological, clinical and therapeutic aspects of atrial fibrillation (AF) in Thies, Senegal. Materials and Methods: This was a retrospective, multicentre, descriptive study from February 1<sup>st</sup>, to May 28<sup>th</sup>, 2019 carried out in the 3 hospitals of the city of Thies that focused on patients with AF documented by an ECG. Valvular and non-valvular AF classification was used and the CHA2DS2-VASc score was used to assess thromboembolic risk. Results: We collected 67 patients with a female predominance (M/F sex ratio of 0.71). The prevalence of AF was 1.7%. The average age of patients was 66.67 ± 13.48 years. Forty-eight patients (71.64%) had palpitations and 32 patients (47.76%) had heart failure. Hypertension was the most common etiological factor found in 41 patients (61.19%) followed by rheumatic valvular disease in 25 patients (37.31%). The non-valvular AF was found in 42 patients (62.69%) of which 34 (80.95%) had a CHA2DS2-VASc score ≥ 2. Vitamin K antagonists (VKAs) were prescribed in 47 patients (79.66%) and aspirin alone in 12 patients (20.34%). Direct Oral Anticoagulants (DOACs) were not prescribed in any patient. Seven patients (10.44%) had a medical regulator treatment and no electrical cardioversion was performed. Conclusion: AF was a frequent rhythm disorder. Hypertension and rheumatic mitral valve disease were the most frequently associated etiological factors. The diagnosis was often late in the heart failure stage. Anticoagulant treatment was insufficiently prescribed and based exclusively on VKAs.展开更多
We report the case of an 18-year-old young man without previous medical history, who was referred for evaluation of an asymptomatic cardiac murmur. Physical examination found holosystolic 4-5/6 apical m...We report the case of an 18-year-old young man without previous medical history, who was referred for evaluation of an asymptomatic cardiac murmur. Physical examination found holosystolic 4-5/6 apical murmur with normal ECG. Bidimensionnal (2D) echocardiography revealed severe mitral regurgitation with thin mitral leaflets. Three dimensional (3D) Echocardiography done for better assessment of mitral valve regurgitation mechanism revealed an isolated mitral leaflet cleft, without signs of endocarditis or traumatic lesion. Regarding the absence of symptoms and excellent maximal exercise tolerance at stress echocardiography, a repair surgery wasn’t offered. Isolated mitral leaflet cleft is a rare congenital anomaly, in adults, the cleft may be an incidental finding that remains asymptomatic for years when the leak is well tolerated. 2D combined with 3D echocardiography is key for diagnosis and surgery guidance.展开更多
Introduction: Cardiovascular diseases are the leading cause of mortality in type 2 diabetics patients. Our work aimed to assess the level of control of type 2 diabetes and associated cardiovascular risk factors. Patie...Introduction: Cardiovascular diseases are the leading cause of mortality in type 2 diabetics patients. Our work aimed to assess the level of control of type 2 diabetes and associated cardiovascular risk factors. Patients and study method: This was an observational cross-sectional study of type 2 diabetics patients. The parameters studied were: sociodemographic data, lifestyle, anthropometric data, levels of control of diabetes by the level of HbA1C, blood pressure measured at the office and cholesterol. Results: 326 type 2 diabetics patients were collected. The sex-ratio was 0.35. The average age of the patients was 58 ± 11 years. A physical inactivity remained present in 79 patients (24.23%), 2 patients (0.61%) continued to smoke. The prevalence of obesity was 21.16% (n = 69) or 25% of women and 10.4% of men (p = 0.01). Abdominal obesity was observed in 151 patients (46.31%), 139 of whom were female and 12 male (p = 0.001). Diabetes was sufficiently controlled in 65.34% of patients (n = 213) while cholesterolemia and hypertension were controlled in 33.44% and 8.33% of patients respectively. Conclusion: Type 2 diabetes was frequently associated with other cardiovascular risk factors. Control of diabetes and these factors was insufficient. Therapeutic education of type 2 diabetics patients needed to be improved.展开更多
A 53 years old female patient with hypertension presented with constrictive retrosternal chest pain. Initial Electrocardiogram (ECG) showed ST elevation in aVR and high level cardiac Troponin-I. Thrombolysis with stre...A 53 years old female patient with hypertension presented with constrictive retrosternal chest pain. Initial Electrocardiogram (ECG) showed ST elevation in aVR and high level cardiac Troponin-I. Thrombolysis with streptokinase was performed and she underwent?coronary angiography who showed a long tight anterior inter ventricular lesion, occlusion of the proximal circumflex and an intermediate lesion of segment 2 of the right coronary.展开更多
Introduction: Venous thromboembolism disease (VTE) is a common complication of hospitalization. Objective: To assess the practice of thromboprophylaxis in hospitalized patients in the department of medicine. Patients ...Introduction: Venous thromboembolism disease (VTE) is a common complication of hospitalization. Objective: To assess the practice of thromboprophylaxis in hospitalized patients in the department of medicine. Patients and Methods: It is an observational cross-sectional study conducted from 01 February to 31 March 2019 in the medical departments of the Saint Jean de Dieu Hospital of Thies. All the patients hospitalized with at least 18 years of age were included. The thromboembolic risk was assessed with the Padua score and thromboprophylaxis?assessed according to the ACCP 2012 recommendations. Results: One hundred and forty four patients were included. Seventy-one (49.3%) were in the high thromboembolic risk category. The most frequently reported risk factors were mobility impairment (n = 72;50%), age of 70 years or above (n = 35;24.3%), heart failure (n = 23;16%), acute infections (n = 14;9.7%) and cancers (n = 13;9.02%). The prevention of venous thromboembolism was practiced in 25 of the 71 patients with high thromboembolic risk or a rate of 35.2%. Thromboprophylaxis was exclusively drug-based with Enoxaparin. Conclusion: The practice of prophylaxis for VTE was low in the medical departments. Efforts still need to be made to reduce the high rate of thromboembolic complications associated with hospitalization.展开更多
文摘Purpose: To describe the epidemiological, clinical and management characteristics of acute coronary syndromes (ACS) in Thies, Senegal. Methods: This was a prospective study that included consecutively from October 1<sup>st</sup>, 2018 to March 03<sup>rd</sup>, 2019, patients aged 18 years or older admitted for an ACS at the DIABCARMET department of the Saint Jean de Dieu Hospital in Thies. Results: Of the 516 patients admitted, 29 had ACS, the prevalence was 5.62%. The average age of the patients was 64.2 ± 11.6 years. Nineteen patients (65.5%) were male and 10 (34.5%) were female, the sex ratio was 1.91. The number of direct admissions was 18 (62%) versus 11 patients (38%) referred. The mode of transport was a private vehicle in 19 patients (65.5%), an ambulance in 7 patients (24.1%) and public transport in 3 patients (10.3%). STEMI (ST segment elevation myocardial infarction) was the most common presentation observed in 19 patients (65.5%). Fifteen patients (51.7%) were admitted before the 12<sup>th</sup> hour. Of the 19 patients with STEMI, 11 (57.9%) had arrived in hospital before the 12<sup>th</sup> hour and 10 patients had streptokinase thrombolysis. No patients received primary PCI. Ten patients (34.5%) had heart failure and five patients (17.2%) died during hospitalization. Conclusion: Delayed consultation and high mortality characterize ACS in Thies. Prevention must be the rule.
文摘Introduction: The objective of this work was to describe the epidemiological, etiological, clinical and therapeutic aspects of atrial fibrillation (AF) in Thies, Senegal. Materials and Methods: This was a retrospective, multicentre, descriptive study from February 1<sup>st</sup>, to May 28<sup>th</sup>, 2019 carried out in the 3 hospitals of the city of Thies that focused on patients with AF documented by an ECG. Valvular and non-valvular AF classification was used and the CHA2DS2-VASc score was used to assess thromboembolic risk. Results: We collected 67 patients with a female predominance (M/F sex ratio of 0.71). The prevalence of AF was 1.7%. The average age of patients was 66.67 ± 13.48 years. Forty-eight patients (71.64%) had palpitations and 32 patients (47.76%) had heart failure. Hypertension was the most common etiological factor found in 41 patients (61.19%) followed by rheumatic valvular disease in 25 patients (37.31%). The non-valvular AF was found in 42 patients (62.69%) of which 34 (80.95%) had a CHA2DS2-VASc score ≥ 2. Vitamin K antagonists (VKAs) were prescribed in 47 patients (79.66%) and aspirin alone in 12 patients (20.34%). Direct Oral Anticoagulants (DOACs) were not prescribed in any patient. Seven patients (10.44%) had a medical regulator treatment and no electrical cardioversion was performed. Conclusion: AF was a frequent rhythm disorder. Hypertension and rheumatic mitral valve disease were the most frequently associated etiological factors. The diagnosis was often late in the heart failure stage. Anticoagulant treatment was insufficiently prescribed and based exclusively on VKAs.
文摘We report the case of an 18-year-old young man without previous medical history, who was referred for evaluation of an asymptomatic cardiac murmur. Physical examination found holosystolic 4-5/6 apical murmur with normal ECG. Bidimensionnal (2D) echocardiography revealed severe mitral regurgitation with thin mitral leaflets. Three dimensional (3D) Echocardiography done for better assessment of mitral valve regurgitation mechanism revealed an isolated mitral leaflet cleft, without signs of endocarditis or traumatic lesion. Regarding the absence of symptoms and excellent maximal exercise tolerance at stress echocardiography, a repair surgery wasn’t offered. Isolated mitral leaflet cleft is a rare congenital anomaly, in adults, the cleft may be an incidental finding that remains asymptomatic for years when the leak is well tolerated. 2D combined with 3D echocardiography is key for diagnosis and surgery guidance.
文摘Introduction: Cardiovascular diseases are the leading cause of mortality in type 2 diabetics patients. Our work aimed to assess the level of control of type 2 diabetes and associated cardiovascular risk factors. Patients and study method: This was an observational cross-sectional study of type 2 diabetics patients. The parameters studied were: sociodemographic data, lifestyle, anthropometric data, levels of control of diabetes by the level of HbA1C, blood pressure measured at the office and cholesterol. Results: 326 type 2 diabetics patients were collected. The sex-ratio was 0.35. The average age of the patients was 58 ± 11 years. A physical inactivity remained present in 79 patients (24.23%), 2 patients (0.61%) continued to smoke. The prevalence of obesity was 21.16% (n = 69) or 25% of women and 10.4% of men (p = 0.01). Abdominal obesity was observed in 151 patients (46.31%), 139 of whom were female and 12 male (p = 0.001). Diabetes was sufficiently controlled in 65.34% of patients (n = 213) while cholesterolemia and hypertension were controlled in 33.44% and 8.33% of patients respectively. Conclusion: Type 2 diabetes was frequently associated with other cardiovascular risk factors. Control of diabetes and these factors was insufficient. Therapeutic education of type 2 diabetics patients needed to be improved.
文摘A 53 years old female patient with hypertension presented with constrictive retrosternal chest pain. Initial Electrocardiogram (ECG) showed ST elevation in aVR and high level cardiac Troponin-I. Thrombolysis with streptokinase was performed and she underwent?coronary angiography who showed a long tight anterior inter ventricular lesion, occlusion of the proximal circumflex and an intermediate lesion of segment 2 of the right coronary.
文摘Introduction: Venous thromboembolism disease (VTE) is a common complication of hospitalization. Objective: To assess the practice of thromboprophylaxis in hospitalized patients in the department of medicine. Patients and Methods: It is an observational cross-sectional study conducted from 01 February to 31 March 2019 in the medical departments of the Saint Jean de Dieu Hospital of Thies. All the patients hospitalized with at least 18 years of age were included. The thromboembolic risk was assessed with the Padua score and thromboprophylaxis?assessed according to the ACCP 2012 recommendations. Results: One hundred and forty four patients were included. Seventy-one (49.3%) were in the high thromboembolic risk category. The most frequently reported risk factors were mobility impairment (n = 72;50%), age of 70 years or above (n = 35;24.3%), heart failure (n = 23;16%), acute infections (n = 14;9.7%) and cancers (n = 13;9.02%). The prevention of venous thromboembolism was practiced in 25 of the 71 patients with high thromboembolic risk or a rate of 35.2%. Thromboprophylaxis was exclusively drug-based with Enoxaparin. Conclusion: The practice of prophylaxis for VTE was low in the medical departments. Efforts still need to be made to reduce the high rate of thromboembolic complications associated with hospitalization.
