Infective endocarditis in hemodialysis patients: A 10-year observational single center study.

BACKGROUND: The incidence of infective endocarditis (IE) in chronic hemodialysis (CHD) patients remains high, despite the preventive measures implemented by nephrologists, especially the rigorous respect of hygiene, the use of antibiotic locks for catheters and the use of tunneled catheters instead of non-tunneled. OBJECTIVE: The objective of this study was to determine the clinical, biological, and echocardiographic characteristics, and the prognosis of IE in CHD. PATIENTS AND METHODS: It was a retrospective study, conducted from December 2010 to March 2020, at the Nephrology and Cardiology units of University Hospital in Oujda, Morocco. RESULTS: We compiled a series of 31 CHD patients having developed IE. Eleven cases (35.4%) were collected between 2010 and 2015, and 20 cases (64.6%) between 2016 and 2020. The mean age was 47 ± 19 years, 58% were male, and 25.8% of patients had diabetes. Vascular access for hemodialysis was by arteriovenous fistula, non-tunneled catheter, and tunneled catheter in 22.5%, 32.2%, and 45.2%, of the cases, respectively. About 25.8% of patients had benefited from more than two catheters (tunneled or non-tunneled) during the 3 months preceding the occurrence of IE. The mitral, tricuspid, and aortic valves were the site of IE in 41.9%, 41.9%, and 13% of the cases, respectively. Right heart IE and left heart IE were observed in 42% (13 cases) and 58% (18 cases) of cases, respectively. Blood cultures were negative in 58.1% of the cases at the time of diagnosis of IE. Staphylococcus aureus was identified in 69.2% of the cases. Mortality occurred in 54.8% of the cases. CONCLUSION: IE remains a severe condition in CHD patients with an increasing incidence. Rigorous prevention and screening strategies should be implemented at the hemodialysis centers.

ST elevation revealing acute myocarditis with SARS cov 2 infection: Case report.

INTRODUCTION: SARS-CoV-2 viral infection can manifested by respiratory symptoms, or other symptoms, such as the cardiovascular manifestations including acute coronary syndrome, pericardial effusion, and heart failure. CLINICAL CASE: A 51-year-old patient admitted to the emergency room for epigastric pain with no respiratory signs and with an ST-segment elevation inelectrocardiogram that ultimately revealed myocarditis and SARS CoV-2 2 infection. CONCLUSION: The clinical manifestations of SARS CoV-2 might be atypical, and the diagnosis might be considered in this pandemic area.

Rare association of aortoarteritis and pheochromocytoma: A case report.

INTRODUCTION: Pheochromocytoma is an uncommon but treatable cause of secondary hypertension, it may present with a wide variety of manifestations. The coexistence of pheochromocytoma and vascular abnormalities is described but rarely reported entity. PRESENTATION OF CASE: A 36-year-old man was admitted to our hospital for severe hypertension, examination revealed absent femoral pulses with notion of intermittent claudication. Abdominal computed tomography revealed the presence of a right adrenal pheochromocytoma. CT angiogram showed thickening of the thoracoabdominal aortic wall and the proximal portions of some of its branches with stenosis of more than 50% of the origin of the celiac trunk, bilateral occlusion of the external iliac arteries and trunk stenosis of the right renal artery. The Pheochromocytoma was surgically removed. DISCUSSION: Coexistence of pheyochromocytoma and vascular abnormalities especially renal artery stenosis and aortoarteritis seems to be an association rather than a coincidence. CONCLUSION: To the best of our knowledge, the coexistence of pheochromocytoma along with both aortoarteritis and renal artery stenosis has not been reported thus far. The diagnosis, management and potential mechanisms underlying such an association will be discussed in this case.

Spontaneous Coronary Artery Dissection (SCAD): A Series of 7 Cases, Experience of the University Hospital Center Mohammed VI, Oujda, Morocco.

Spontaneous coronary artery dissection is a less known pathology by the cardiologists and represents a real challenge especially to the interventional cardiologist. The positive diagnosis is based on the visualization of intimal flap with the false lumen by intracoronary imaging means. This entity particularly interests young people without classic cardiovascular risk factors of atherosclerosis and female during the peripartum period. We report, in this paper, our experience in the University Hospital Center of Mohammed VI, Oujda, Morocco, about 7 cases diagnosed by coronary angiography during 3 years of practice while comparing our results with data from large series published in the literature. The purpose of this work is to draw more attention to this particular pathology that is becoming more and more common.