Epidemiological African Day for Evaluation of Patients at Risk of Venous Thrombosis in Acute Hospital Care Settings : Cardiovascular Topic

Introduction : This study aimed to identify patients at risk for venous thromboembolism (VTE) among all patients hospitalised; and to determine the proportion of at-risk hospital patients who received effective types of VTE prophylaxis in sub-Saharan Africa (SSA). Methods: A multinational; observational; cross-sectional survey was carried out on 1 583 at-risk patients throughout five SSA countries. Results: The prevalence of VTE risk was 50.4 overall; 62.3 in medical and 43.8 in surgical patients. The proportion of at-risk patients receiving prophylaxis was 51.5 overall; 36.2 in medical and 64 in surgical patients. Low-molecular weight heparin was the most frequently used prophylactic method in 40.2 overall; 23.1 in medical and 49.9 in surgical patients. Discussion: This study showed a high prevalence of VTE risk among hospitalised patients and that less than half of all at-risk patients received an American College of Clinical Pharmacy-recommended method of prophylaxis. Conclusion: Recommended VTE prophylaxis is underused in SSA

A Review of Chest Pain in Nigerian Hypertensive Patients Presenting to the Out-Patient's Clinic of a Teaching Hospital

In a prospective 6-month study; chest pain was reviewed in hypertensive man above 40 years and post menopausal women on antihypertensive therapy. The subjects were made up of 230 volunteers made up of 101 males and 129 females. Their mean age was 54.5 + 10 years (males 51.3 + 8.9 years vs. female 53.3 + 9.8 years). Forty seven percent of subjects admitted to pain as being located in the retrosternal area; in 38 it was cited at the precordial area and the remainder (9) cited the pain on the right side of the chest and 6 submamary. Twenty six percent and 22 of subjects described pain as being pressure like or dull consecutively. In 42 of patients pain was aggravated by exertion; in 32 of subjects pain had no aggravating factor; 14 and 3 had pain aggravated by hunger and the use of non steroidal anti-inflammatory agents. In the remaining 9 pain was aggravated by breathing particularly during the inspiratory phase of respiration. The relieving factors described include rest in 34; analgesia in (25); change of position in 4 and antacid in 12. In the remaining 25 no relieving factor was identified. Pain radiation was described was mainly to the epigastrium. Based on the symptoms; 11 had all the three parameters of pain description suggestive of angina pectoirs. 5 of patients had symptom suggestive of atypical angina and 17 had just one character present and considered non cardiac. The difference in serum cholesterol level in patients described as having classic angina and atypical were statistically significantly higher than those in subjects who did not complain of chest pain. Patients with atypical chest pain had the highest blood pressure; those with non cardiac pain had the highest WHR while those with no pain had the highest BMI. A proper approach to patients with chest pain irrespective of how trivial it may seem; should include a careful description and characterization of the chest pain; careful and a thorough physical examination. A rational and judicious utilisation of facilities should be employed carrying out the available investigations and possibly following chest pain protocols.

Electrocardiographic and echocardiographic findings of Nigerian athletes. A Lagos Study

Summary In a prospective study spanning over 6 months involving one hundred and nineteen male and female subjects comprising 98 Nigerian athletes and 55 age and sex matched controls all had electrocardiography and echocardiographic assessment of left ventricular dimensions and systolic function. Athletes were found to have significant prevalence of bradycardia when compared to the non-athletes. (P=0.03). In addition a greater percentage of the athletes had T wave invertion in the anterior leads (V1-V3) and electrocardiographic features consistent with left ventricular hypertrophy; and first-degree heart block. Athletes were also found to have significantly larger left ventricular end diastolic dimension (p0.01); increased left ventricular posterior wall thickness (p0.01); greater left ventricular mass (p0.01) and left ventricular mass index (p0.01) than the control group. These parameters were found to be significantly higher in each gender category as well. Power trained athletes were found to have greater relative left ventricular wall thickening when compared to the endurance trained athletes. Left ventricular systolic functions of both categories of athletes were found to be within normal limits and better than the control group. None of the athlete had echocardiographic features suggestive of hypertrophic cardiomyopathy

Asymmetric septal hypertrophy and systolic anterior motion of the mitral valve in a patient with pulmonic stenosis and complete heart block: a rare association [case report]

Apart from hypertrophic cardiomyopathy; asymmetric septal hypertrophy has been reported in many disease entities. Its association with pulmonic stenosis although not unknown is none the less rare (1;2). We present the case of a 21 year old back female student who presented with a 2 day history of chestpain; dyspnoea and syncope. She had intermittent dizziness exertional dyspnea and palpitations in the antecedent nine years. She also later admitted to progressive effort intolerance since childhood. Her referal letter stated that she was diagnosed as having hypertrophic cardiomyopathy. The previous echo had been prompted by a University preadmission electrocardiographic finding of multiple multiforal ventricular ectopics