[Cardiovascular retention of drepanocytosis]

Sickle cell disease is an autosomal recessive genetic disease characterized by the formation of abnormal hemoglobin S [HbS]. There are several forms of sickle cell disease: SS homozygous, heterozygous and thalassemic. Cardiovascular complications are increasingly evident; this is related to the increased life expectancy of patients with hemoglobinopathies: rhythm and conduction disorders, heart failure and pulmonary artery hypertension. These cardiovascular complications represent the major prognostic factor of sickle cell disease. Through this review of the literature we will describe the clinical and paraclinical aspects of cardiac involvement during sickle cell anemia

[Kidney disease in high hypertension]

The relation between hypertension and kidney disease is difficult to distinguish if the kidney disease is the cause or the consequence of hypertension or there is an other factor responsible. The aim of this study is to analyse the different kidneys damage in a group of hypertensive outpatients. It's a prospective study including 185 patients. The OMS criteria were necessary to have a confirmation of hypertension. The check up contained "azotaemia, creatininaemia, kaliaemia, natriaemea, alburninuria ". All the patients had a kidney ultrasonography. This study included l46females and 39 males. The average age was 48 years. Most of the patients [43%] were aged from 50 to 60 years. Kidney damage was found in 56 cases. There are 2 types of kidney disease in hypertension. The malignant nephroangiosclerosis found in accelerated hypertension and glomerulo-sclerosis with slow evolution noted in moderated hyper-tension and diabetes. Even though a benign kidney disease may be found in a hypertension and patient, it may be a sign of more important vascular and kidney risk and justifies vigilant surveillance

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