[Characteristics of chest pain in acute coronary syndromes seen in the cardiology department of Befelatanana (Madagascar)]. / Caractéristiques des douleurs thoraciques au cours des syndromes coronariens aigus vus au service de cardiologie de Befelatanana (Madagascar).

INTRODUCTION: Chest pain is one of the different elements of orientation for the diagnosis of acute coronary syndrome. Sometimes its clinical presentation is misleading. The objective of this study was to describe the characteristics of chest pain during an acute coronary syndrome in the cardiology department of the Joseph Raseta Befelatanana University Hospital Center, Antananarivo, Madagascar. METHODS: We carried out a cross-sectional, descriptive study of 10 months from January 2019 to October 2019. All patients diagnosed with acute coronary syndrome during this period were included. RESULTS: Sixty-five cases were included. A "typical chest pain" was only encountered in 7.7% of cases. Advanced age (p = 0.04) and sedentary lifestyle (p = 0.03) were associated with the occurrence of silent myocardial ischemia, and. hypertension with a prolonged duration (≥15 minutes) of chest pain (p = 0.03). Dyslipidemia was associated with atypical irradiation of chest pain (p = 0.003). Alcoholism had an impact on pain triggered by effort (p = 0.01) and relieved by rest (p = 0.04). CONCLUSION: The current symptomatology of acute coronary syndrome is increasingly atypical. Knowledge of the factors that can influence the different characteristics of chest pain could serve as a benchmark in clinical practice in our population.

[Libman-Sacks endocarditis superinfected: a case report]. / Endocardite de Libman-Sacks surinfectée: à propos d'un cas.

Libman-Sacks endocarditis is a rare cardiac manifestation systemic lupus erythematosus, in which there is a sterile vegetation in the heart valves. There is a significant risk of infective endocarditis. Our patient was a 38 year old woman with persistent fever from two months with inflammatory polyarthralgia, fixed at the wrists and ankles. She was febrile at 39 ° C, had a mitral systolic murmur 2/6 and painful swelling of the wrists and ankles. We have objectified an inflammatory syndrome, blood cultures were negative. The dosage of anti-nuclear antibody was positive with a mottled appearance, as well as anti-DNA antibodies. The Doppler echocardiography had objectified vegetations in the mitral and aortic valves. Clinical, biological and morphological improvements were obtained after antibiotic and corticosteroid combination. We can conclude that Libman-Sacks endocarditis evolution is favorable in the absence of an associated antiphospholipid syndrome (APS). Always fear in all cases a surinfection. The treatment is based on the combination antibiotic-corticosteroid-synthetic antimalarial.

[Reversible dilated cardiomyopathy induced by hypocalcaemia secondary to hypoparathyroidism after total thyroidectomy: about a case]. / Une cardiomyopathie dilatée réversible induite par l'hypocalcémie secondaire à une hypoparathyroïdie post thyroïdectomie totale: à propos d'un cas.

We here report the case of a 38-year old woman with dilated cardiomyopathy induced by hypocalcaemia secondary to hypoparathyroidism. The patient had low calcium level (30 mg/L) and echocardiography showed dilated-hypokinetic cardiomyopathy with reduced left ventricular ejection fraction (31.4%). She received calcitherapy associated with vitamin D3 and her evolution was marked by the normalization of the size of the cardiac cavities and of the left ventricular ejection fraction after normocalcemia.

Prevalence of selected cardiometabolic risk factors among adults in urban and semi-urban hospitals in four sub-Saharan African countries.

AIM: Cardiovascular diseases (CVDs) are a global challenge but the burden in sub-Saharan African (SSA) countries is less well documented than elsewhere. We aimed to describe the key cardiometabolic risk factors in four SSA countries. METHODS: A cross-sectional, multi-national, hospital-based study was carried out among adults (> 35 years) across four SSA countries from 12 December 2011 to 7 February 2013. Risk factors were defined using the World Health Organisation and International Diabetes Federation guidelines. RESULTS: Of the 844 adults (57.4% female, mean age 52.6 years), 76.6% were urban residents. The predominant CVD risk factors were hypertension (74.1%), obesity (36.2%) and excessive alcohol consumption (25.6%). Diabetes (17.7 vs 10.0%), obesity (42.8 vs 16.8%) and hypercholesterolaemia (25.8 vs 18.0%) were more prevalent among the hypertensive subjects (all p < 0.007) than the normotensives. The metabolic syndrome (39.4%) was more common in women and hypertensive subjects. CONCLUSIONS: Hospital patients in SSA countries present with excessive rates of cardiometabolic risk factors. Focus on their prevention and control is warranted.

Epidemiological African day for evaluation of patients at risk of venous thrombosis in acute hospital care settings.

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.

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