Acute myocardial infarction in women during childbearing age is rare. We report a case of a 40-year-old female patient with no history or cardiovascular risk factors, 24-week</span><span style="font-fami...Acute myocardial infarction in women during childbearing age is rare. We report a case of a 40-year-old female patient with no history or cardiovascular risk factors, 24-week</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">pregnant who presented with acute coronary syndrome with an ST-elevation anterior extended complicated by cardiogenic shock. Cardiac ultrasound showed systolic dysfunction of the left ventricle at 30%. Emergency coronary angiography revealed subocclusion of the proximal anterior interventricular artery. We performed a primary angioplasty with placement of a stent after balloon predilation with a satisfactory agiographic result and an improvement in the hemodynamic state. The patient gave birth by cesarean section at 30 weeks of pregnancy after a pocket rupture of infectious waters. The newborn died after 72 hours. After 6 years of evolution, the patient remained asymptomatic under medal treatment.展开更多
The association between aortic insufficiency and sinus dysfunction is rare. We reported a case of significant chronic degenerative aortic insufficiency associated with sinus dysfunction. This was a 66-year-old patient...The association between aortic insufficiency and sinus dysfunction is rare. We reported a case of significant chronic degenerative aortic insufficiency associated with sinus dysfunction. This was a 66-year-old patient on follow-up for asymptomatic chronic aortic insufficiency who was referred to us for a preoperative invasive hemodynamic assessment. The indication for surgery was based on the left ventricular dilation criteria. The echocardiography and cardiac catheterization showed a disappearance between the aortic insufficiency and the left ventricular repercussion. Upon discovery of the sinus bradycardia, the patient received a single chamber pacemaker set at a base rate of 70 seconds in AAIR at first and then the patient was measured remotely. At five months, cardiac pacing resulted in a significant reduction in the left ventricular diameter and volume on the echocardiography and magnetic resonance imaging;therefore surgery was postponed.展开更多
Introduction: Degenerative aortic stenosis is the most common valvulopathy in developed countries. The implantation of a percutaneous aortic valve (TAVI) has taken an important place in the management of this valvulop...Introduction: Degenerative aortic stenosis is the most common valvulopathy in developed countries. The implantation of a percutaneous aortic valve (TAVI) has taken an important place in the management of this valvulopathy. The objective of this work is to report the results of patients treated by TAVI by the team of Sainte Clotilde Hospital (Reunion Island). Patients and?Methods: This was a descriptive retrospective study conducted from 01/10/2014?to 01/10/ 2017 in the Sainte Clotilde Hospital, Reunion Island. All patients who received TAVI for degenerative aortic stenosis were included in the study. Follow-up was completed until 31/08/19. Results: Forty-six (46) patients were included (sex ratio 0.53). The age was 82 (±7.5). Respectively,?56.5%, 21.7% and 6.5% of patients were diabetic [n = 26 (56.5%)], severe renal impairment [n = 10 (21.7%)] and hemodialysis [n = 3 (6.5%)]. All procedures were performed by femoral route under consious sedation. Edwards’ prostheses were used more often (93%), 100% Sapien 3, 6% of which were size 23. The primary success rate was 97.8% and the failure rate was 2% (deaths per procedure). The TAVI range of 0.66 ± 0.14 and 46.8 ± 15.5 against 1.48 ± 4.3 and 13.8 ± 5 in post TAVI. Severe pulmonary arterial?hypertension (>60 mmHg) was observed in 21.7% of pre-TAVI patients?compared to 4% in post TAVI patients. The overall rate of complications was 17% (n = 8). They were related to conductive disorders [6.5% (n = 3)], paraprosthetic leakage [2% (n = 1)], tamponade [2% (n = 1)], and hemorrhagic complications [6.5% (n = 3)]. Mean follow-up was 946 days (median = 1007.5 days), mean follow-up death rate was 30.4% (n = 14). The causes of death were non-cardiac in 57% (n = 8) of the cases. Conclusion: The TAVI results of the Sainte Clotilde Hospital Clinic are comparable to those observed in the literature.展开更多
Introduction: Cardiac Insufficiency is progressively taking over as the leading cause of morbidity and mortality in the world and a major public health problem in Chad. Our study was to contribute and provide a deeper...Introduction: Cardiac Insufficiency is progressively taking over as the leading cause of morbidity and mortality in the world and a major public health problem in Chad. Our study was to contribute and provide a deeper understanding of the clinical and etiological aspects concerning the etiology and management of Cardiac Insufficiency in N’Djamena, Chad. Due to having no published data to distinctly understand this pathology in this part of the world, we represent here a summary of available data which could be used to describe the clinical and etiological aspects of Cardiac Insufficiency and to help in changing practices for an optimal management as a baseline for comparison in future studies. Patients and Methods: This was a prospective, descriptive study conducted from November 30th 2011 to May 30th 2013 at the Good Samaritan Hospital of N’Djamena. Results: 100 hospitalized patients were included consecutively. The sex ratio was 1.08 with an average age of 40.21 ± 21.30 years. The main cardiovascular risk factors were high blood pressure (15%), obesity (12%) and diabetes (11%). Clinically, exertional dyspnea was found in 95% of cases, and signs of congestive heart failure in 61% of cases. The etiologies were 50% of Rheumatic valvulopathy, 22% of Dilated cardiomyopathy, 13% of Hypertensive cardiomyopathy and 12% of Congenital heart disease. Conclusion: The most common etiologies were Rheumatic valvulopathy, Congenital heart disease, Dilated cardiomyopathy and Hypertensive cardiomyopathy.展开更多
文摘Acute myocardial infarction in women during childbearing age is rare. We report a case of a 40-year-old female patient with no history or cardiovascular risk factors, 24-week</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">pregnant who presented with acute coronary syndrome with an ST-elevation anterior extended complicated by cardiogenic shock. Cardiac ultrasound showed systolic dysfunction of the left ventricle at 30%. Emergency coronary angiography revealed subocclusion of the proximal anterior interventricular artery. We performed a primary angioplasty with placement of a stent after balloon predilation with a satisfactory agiographic result and an improvement in the hemodynamic state. The patient gave birth by cesarean section at 30 weeks of pregnancy after a pocket rupture of infectious waters. The newborn died after 72 hours. After 6 years of evolution, the patient remained asymptomatic under medal treatment.
文摘The association between aortic insufficiency and sinus dysfunction is rare. We reported a case of significant chronic degenerative aortic insufficiency associated with sinus dysfunction. This was a 66-year-old patient on follow-up for asymptomatic chronic aortic insufficiency who was referred to us for a preoperative invasive hemodynamic assessment. The indication for surgery was based on the left ventricular dilation criteria. The echocardiography and cardiac catheterization showed a disappearance between the aortic insufficiency and the left ventricular repercussion. Upon discovery of the sinus bradycardia, the patient received a single chamber pacemaker set at a base rate of 70 seconds in AAIR at first and then the patient was measured remotely. At five months, cardiac pacing resulted in a significant reduction in the left ventricular diameter and volume on the echocardiography and magnetic resonance imaging;therefore surgery was postponed.
文摘Introduction: Degenerative aortic stenosis is the most common valvulopathy in developed countries. The implantation of a percutaneous aortic valve (TAVI) has taken an important place in the management of this valvulopathy. The objective of this work is to report the results of patients treated by TAVI by the team of Sainte Clotilde Hospital (Reunion Island). Patients and?Methods: This was a descriptive retrospective study conducted from 01/10/2014?to 01/10/ 2017 in the Sainte Clotilde Hospital, Reunion Island. All patients who received TAVI for degenerative aortic stenosis were included in the study. Follow-up was completed until 31/08/19. Results: Forty-six (46) patients were included (sex ratio 0.53). The age was 82 (±7.5). Respectively,?56.5%, 21.7% and 6.5% of patients were diabetic [n = 26 (56.5%)], severe renal impairment [n = 10 (21.7%)] and hemodialysis [n = 3 (6.5%)]. All procedures were performed by femoral route under consious sedation. Edwards’ prostheses were used more often (93%), 100% Sapien 3, 6% of which were size 23. The primary success rate was 97.8% and the failure rate was 2% (deaths per procedure). The TAVI range of 0.66 ± 0.14 and 46.8 ± 15.5 against 1.48 ± 4.3 and 13.8 ± 5 in post TAVI. Severe pulmonary arterial?hypertension (>60 mmHg) was observed in 21.7% of pre-TAVI patients?compared to 4% in post TAVI patients. The overall rate of complications was 17% (n = 8). They were related to conductive disorders [6.5% (n = 3)], paraprosthetic leakage [2% (n = 1)], tamponade [2% (n = 1)], and hemorrhagic complications [6.5% (n = 3)]. Mean follow-up was 946 days (median = 1007.5 days), mean follow-up death rate was 30.4% (n = 14). The causes of death were non-cardiac in 57% (n = 8) of the cases. Conclusion: The TAVI results of the Sainte Clotilde Hospital Clinic are comparable to those observed in the literature.
文摘Introduction: Cardiac Insufficiency is progressively taking over as the leading cause of morbidity and mortality in the world and a major public health problem in Chad. Our study was to contribute and provide a deeper understanding of the clinical and etiological aspects concerning the etiology and management of Cardiac Insufficiency in N’Djamena, Chad. Due to having no published data to distinctly understand this pathology in this part of the world, we represent here a summary of available data which could be used to describe the clinical and etiological aspects of Cardiac Insufficiency and to help in changing practices for an optimal management as a baseline for comparison in future studies. Patients and Methods: This was a prospective, descriptive study conducted from November 30th 2011 to May 30th 2013 at the Good Samaritan Hospital of N’Djamena. Results: 100 hospitalized patients were included consecutively. The sex ratio was 1.08 with an average age of 40.21 ± 21.30 years. The main cardiovascular risk factors were high blood pressure (15%), obesity (12%) and diabetes (11%). Clinically, exertional dyspnea was found in 95% of cases, and signs of congestive heart failure in 61% of cases. The etiologies were 50% of Rheumatic valvulopathy, 22% of Dilated cardiomyopathy, 13% of Hypertensive cardiomyopathy and 12% of Congenital heart disease. Conclusion: The most common etiologies were Rheumatic valvulopathy, Congenital heart disease, Dilated cardiomyopathy and Hypertensive cardiomyopathy.