[Cardiothyrotoxicosis]

About a retrospective study of 20 cases of cardiothyreosis, collected at the cardiology department of University Hospital Ibn Rochd of Casablanca, during a period of7 years, we can pilot the following data: woman predominence is obvious [80%], the average is advanced [52 years old], the notion of preexistent cardio-vascular pathology is noted on 8 cases [40%], the goitre basedowing is the frequent aetiology of hyperthyreosis; the cardiac complications of hyperthyroidism are dominated by the disorders of rhythm [95%] and the heart failure [75%]. The treatment of cardiothyreosis is always double: the anti thyroidism therapy associate cardiac treatment where the beta blockers take an important place. On the evolutive level, the return to the euthyroidism is generally obtained, however it can persist the cardiovasculary disorders, in particular, the cardiac arrhythmia which is difficult to reduce

[Tuberculos pericarditis [about 220 cases]]

Between January 1977 and December 1989, 220 cases of tuberculosis pericarditis were diagnosed in the cardiology ward of the Medical School Ibn Rochd Hospital of Casablanca. They fell into three broad catergories: - acute pericarditis: 130 cases [59%] - sub-acute pericarditis: 40 cases [18%] - constrictive pericarditis: 50 cases [23%]. The average of the patients was 30 years, a majority being male [65%]. Forty-four cases of acute pericarditis were admitted with a tamponade. The cases of sub-acute pericarditis were distinguished by respiratory difficulties [95%] and signs of constriction [95%]. The cases of constrictive pericarditis were all characterized by the existence of Pick's syndrome [100%]. The diagnosis of tuberculosis was certain in 44 cases [20%], and was made with strong basis for assumption in the remaining 80%. We regret the 18 deaths that resulted during this study. Forty- three patients were seen again after an average delay of 47 months; development in 32 cases judged to be good, and stable in 7 other cases. Four later deaths were also recorded

Apparently primitive dilated cardiomyopathy. About 30 cases

This retrospective study was conducted in the Cardiology Unit of the University Hospital Ibn Rochd Casablanca. Thirty cases of primary cardiomyoparhy were recorded between 1980 and 1985. -Frequency of the disease [0.42%] was underestimated. - The mean age of the patients was 37.5 years; Most of them were males [73%]. - The clinical picture was a cardiac failure [96.6%] which was bilateral in 73.3%. - Electrocardiogram was always disturbed, but there was no specific sign. Q and QS waves of transmural fibrosis were frequently associated [33.3%]. -Echocardiography was a privileged technique for studying the dilated cardiomyopathy; it allows the diagnosis and the study of the ventricular function which is an important element in the prognosis evaluation. Treatment remains disappointing, based on the combination of rest, salt free diet associated which diuretics and digitalis. - Etiology is still unkown and the prognosis poor. - Death rate was 23.3%. Mean duration of survival was 12 months. - Two cases of this disease were of interest: a post-partum myocardiopathy and an alcoholic myocardiopathy

Chronic cor pulmonary resulting from tuberculosis

From 1977 to 1985, 78 patients with Chronic Cor Pulmonale resulting from antecedent tuberculosis have been treated in the cardiology department of Ibn Rochd Hospital, Casablanca, Morroco. The responsability of tuberculosis is predominant in the setting of the disease [30%]. Eight years was the mean time elapsed between the tuberculosis and the Cor Pulmonale. All patients were seen with right heart failure. The most frequent complications were acute respiratory failure [80%], supra-ventricular arrythmias [18%] and digestive tract bleeding [6.5%]. 42% died, most of them from acute respiratory failure. Survival rate was 52% nearly eight years after the onset of the cor pulmonale

Permanent cardiac stimulation

Our study covers twenty cases of "permanent electro-systolic pacers" used in the Cardiology Department of the Ibnou Rochd Hospital in Casablanca from 1976 to 1984. Our series have noted that: - The average relatively young age of our patients [48] with a predominance of complete congenital auriculo-ventricular blocks [BAV]. - The indications of stimulation have to be permanently watched because of the vital risk to our patients of repeated fainting and cardiac refractory insuffiency. - The almost exclusive adoption of endo-cavitory wey with the use of litium sentry batteries [QRS-] and monopolar probes. A conventional clinical, electrical and radiological supervision has been set up. - Immediately after the operation, where we have noted two displaced probes, which were put back in position on the ventricular right at the point level, and one infection of the casing put right by a change of batteries and probe. - The long term evolution after a period of 14 months is clear cut: - one case of worn sheath. - one case of displaced probe. - and two cases of worn out batteries. The reintervention in order to change the failed material has been practised in all cases

Pulmonary hypertension secondary to pulmonary asbestos. About 3 cases

After having during twenty years in a factory using asbestos cement, three morkmen have presented pulmonary fibrosis that manifested itself by a severe dyspnea, cough and expectoration, radiologically by diffuse pulmonary lesions with basal predominance and linear disposition, associated to a pleural calcification characteristic of the asbestosous origin. During the evolution, this pulmonary fibrosis has been complicated by chronic cor pulmonale: right ventricular hypertrophy and a pulmonary hypertension in those cases