ABSTRACT
INTRODUCTION: Infective endocarditis is a rare but potentially severe disease, associated with significant morbidity and mortality. Our study aims to describe the epidemiology and management aspects of endocarditis in northern Morocco and compare it with international management guidelines. MATERIALS AND METHODS: This is a retrospective study involving all patients hospitalized in the cardiology department of the University Hospital of Tangier for infective endocarditis over a period of 4 years and 7 months, from May 2019 to February 2024. RESULTS: Eighty patients were hospitalized for IE during the study period. The average age of the patients was 46 years, with an even sex ratio. IE concerned native valves in 77% of cases, mechanical prostheses in 19% of cases, and on bio prostheses in 4%. The average diagnostic delay was 25 days. Blood cultures were negative in 59% of cases. The predominant infective microorganism was the bacteria Staphylococcus (65.6%). Imaging results showed vegetations in 76.3% of cases, predominantly on the mitral valve (39.3%), followed by the aortic valve (21.3%). The main complications included heart failure (51.2%), peripheral arterial embolisms (22.5%) and splenic infarction (17.5%). Management wise, the most commonly used antibiotic therapy was a combination of ceftriaxone and gentamicin. Clinical and biological improvement was observed in 70% of cases, with a mortality rate of 12.5%. Twelve patients underwent surgery (15%). Urgent surgery was indicated in 66,7% of the operated patients. CONCLUSION: Our study highlights the challenges in managing infective endocarditis in northern Morocco. The prognosis of infective endocarditis can be improved through multidisciplinary management within the implementation of an Endocarditis Team.
Subject(s)
Anti-Bacterial Agents , Endocarditis , Humans , Morocco/epidemiology , Male , Female , Middle Aged , Retrospective Studies , Adult , Prognosis , Endocarditis/epidemiology , Endocarditis/microbiology , Endocarditis/diagnosis , Endocarditis/therapy , Endocarditis/mortality , Anti-Bacterial Agents/therapeutic use , Aged , Endocarditis, Bacterial/epidemiology , Endocarditis, Bacterial/microbiology , Endocarditis, Bacterial/mortality , Endocarditis, Bacterial/diagnosis , Endocarditis, Bacterial/drug therapy , Young Adult , AdolescentABSTRACT
Chronic constrictive pericarditis is a rare condition characterized by clinical signs of right heart failure, due to the symphysis of the two pericardial leaflets. Our study focused on a retrospective analysis of 43 CCP surgery observations collected over an 11-year period (2003-2013). The mean age of the patients was 32 years; 65% were male; exercise dyspnea (95%) was the most frequent sign. Two main etiologies were observed: tuberculosis 58% and idiopathic causes 42%. All of our patients received a subtotal pericardectomy per median sternotomy, of which 95% had no cardiopulmonary bypass.
Subject(s)
Pericardiectomy , Pericarditis, Constrictive , Humans , Pericarditis, Constrictive/surgery , Male , Retrospective Studies , Female , Adult , Middle Aged , Young Adult , Adolescent , Treatment OutcomeABSTRACT
Coronary artery embolism is an uncommon cause of myocardial infarction (MI). Among several etiologies of coronary embolism, we mention a very rare cause which is the paradoxical embolism via patent foramen ovale (PFO). It interests generally youngest people without cardiac risk factors. We report three cases who presented ST-elevation MI (STEMI) due to paradoxical embolism with high risk PFO that can justify embolic infarction. The aim of this article is to define the high risk PFO, to establish causal link between PFO and embolic events and to guide therapeutic management.
Subject(s)
Acute Coronary Syndrome , Embolism, Paradoxical , Embolism , Foramen Ovale, Patent , Myocardial Infarction , ST Elevation Myocardial Infarction , Humans , Embolism, Paradoxical/etiology , Acute Coronary Syndrome/complications , Foramen Ovale, Patent/complications , Embolism/etiology , Myocardial Infarction/etiology , ST Elevation Myocardial Infarction/complicationsABSTRACT
Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndromes (ACS) that mainly occurs in young women with no risk factors and no coronary atherosclerosis. Diagnosis is made by invasive coronary angiography (CA), computed tomography coronary angiography (CTCA), intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The rarity of this entity as well as the complications of invasive treatment make it difficult to choose therapy between conservative management, percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). We report a case of a 36-year-old woman presented with non ST elevation myocardial infarction (NSTEMI) related to spontaneous dissection of coronary arteries (left main trunk, left anterior descending artery and left circumflex artery) treated medically with spectacular results at 2 months, controlled by CTCA.
Subject(s)
Conservative Treatment/methods , Coronary Vessel Anomalies/therapy , Vascular Diseases/congenital , Adrenergic beta-Antagonists/therapeutic use , Adult , Aspirin/therapeutic use , Computed Tomography Angiography , Coronary Angiography , Coronary Vessel Anomalies/complications , Coronary Vessel Anomalies/diagnosis , Echocardiography , Female , Humans , Non-ST Elevated Myocardial Infarction/diagnosis , Non-ST Elevated Myocardial Infarction/therapy , Platelet Aggregation Inhibitors/therapeutic use , Vascular Diseases/complications , Vascular Diseases/diagnosis , Vascular Diseases/therapyABSTRACT
Endomyocardial biopsy (EMB) remains the gold standard method for diagnosis of cardiac allograft rejection. Complications following EMB rarely occur, however, it can lead to coronary cameral fistulae (CCF). We describe the case of a 65-year-old patient admitted for lateral STEMI related to a fistula communicating the distal part of the left anterior descending artery (LAD) with the right ventricle after EMB biopsy, which was incompletely closed with a covered stent.
