[Comparative prognosis of pulmonary embolism in patients infected with COVID-19 and patients not infected with COVID-19 in Ouagadougou]. / Pronostic comparé de l'embolie pulmonaire chez les patients infectés au COVID-19 et les patients non infectés au COVID-19 à Ouagadougou.

OBJECTIVE: the study's objective was to determine impact of COVID-19 on the prognosis of pulmonary embolism. PATIENTS AND METHODS: An analytical multicenter cross-sectional study with retrospective data collection was carried out in three university hospitals and a private clinic in Ouagadougou from March, 2020 to July 2021. It included consecutive patients hospitalized for PE confirmed on chest CT angiography or by the association an acute cor pulmonale on echocardiography-Doppler with deep vein thrombosis on venous ultrasound-Doppler of the lower limbs and having carried out a COVID-19 test (RT-PCR or rapid diagnostic test). Control cases consisted of all COVID-19 negative PE cases. Data comparison was carried out using the Epi info 7 software. A univariate then multivariate analysis allowed the comparison of the prognosis of the two subpopulations. The significance level retained was p < 0.05. RESULTS: 96 patients with COVID-19+ and 70 COVID-19- PE were included. The prevalence of PE in patients hospitalized for COVID-19 was 7.05%. The average patient age was 61.5±17 years for COVID-19+ patients and 49.6±15.9 years for COVID-19- patients. Pulmonary condensation syndrome (p=0.007), desaturation (p=0.0003) and respiratory distress syndrome (p=0.006) were more common in COVID-19+ patients. The hospital death rate was 27.1% in COVID-19+ patients and 10% in COVID-19- patients (p=0.0024). Age > 65 years and COVID-19 pneumonia were the independent factors of death. CONCLUSION: COVID-19 is associated with clinical severity and excess mortality in patients with pulmonary embolism.

[Contribution of the 6-minutes walking test and the plasma NT-proBNP at admission and discharge to the prognostic evaluation of patients with NYHA class II-III Heart Failure.] / Contribution du test de marche de six minutes et des taux de NT-proBNP à l'admission et la sortie dans l'évaluation pronostique de l'insuffisance cardiaque classe II-III de la NYHA.

OBJECTIVE: To study the 6MWT and NT-proBNP contribution to the prognosis evaluation of patients with NYHA class II-III heart failure in the Yalgado Ouédraogo Teaching Hospital. METHODS: We carried out a nine months prospective observational cohort from the 1st February to the 31st October 2020. Patients with NYHA class II-III HF who consented to participate were included in the study. We identified two variables of interest: death and readmission. RESULTS: We included 50 patients with congestive heart failure representing 37.3% of heart failure. The average follow up time of patients was 154.58 ± 74.8 days. Twelve patients (24%) were readmited and 11 passed away with five during hospitalisation. On admission, The average distance on the 6MWT (194.6 ± 85.5 m) on admission and average NT-proBNP (5812.1±4729.4 ng/L) measured on admission and before discharge wasn't significantly correlated to the risk of death and re-hospitalisation. The average distance on the 6MWT before discharge (306.2±84.6) was significantly correlated to an increase risk of death and re-hospitalisation. Patients with an increase in NT-proBNP superior to 30% from measurement on admission to the one before discharge had a high risk of re-hospitalisation and death compare to those with a decrease of more than 30% with a moderate to good correlation coefficient of 0.6 between the two. CONCLUSION: 6MWT and NT-proBNP variations from admission to discharge have been necessary to evaluate the prognosis of patients with CHF.

[Characteristics of effusive pericarditis in N'Djamena (Chad)]. / Caracteristiques des pericardites liquidiennes a N'Djamena (Tchad).

INTRODUCTION: Pericarditis is a commun cause of hospitalisation in cardiology and internal medicine wards. OBJECTIVE: We aimed to describe the epidemiological profile of effusive pericarditis at the Department of cardiology of the National Referral Teaching Hospital of N'Djamena, Chad. METHODS: We undertook a descriptive cross-sectional study from January 2017 to December 2019. Patients presenting with effusive pericarditis and who consent to participate were consecutively enrolled during the study period. RESULTS: Overall, 1805 patients were hospitalized at the department of cardiology during the study period with effusive pericarditis accounting for 4.3% of all cases (n = 78). Patients' mean age was 35.84 ± 14 years, [range 16 and 73 years]. The sex ratio was 0.89. Exertional dyspnea, chest pain, poor general condition and fever were main symptoms reported in 90%, 89%, 81% and 51% of the cases respectively. Pericardial rub was found in 51% of the study patients. Eighteen patients (26%) were HIV positive and 97% of the study patients had cardiomegaly. ECG demonstrated low QRS voltage (97%) and diffuse abnormalities of repolarisation (96%). Pericardial effusion was found abundant in 57% of the cases. Etiologies of effusive pericarditis were mainly tuberculosis (47%), idiopathic (21%) and HIV infection (13%). Thirty patients (43%) benefited from pericardiocentesis. The in-hospital mortality rate of the disease was 17%. CONCLUSION: Effusive pericarditis is frequent and associated with poor outcome. Treatment depends on etiology dominated by tuberculosis in Chad.

INTRODUCTION: Les péricardites représentent une cause fréquente d'hospitalisation en cardiologie et en médecine interne. OBJECTIF: Décrire les caractéristiques épidémiologiques et étiologiques des péricardites liquidiennes dans le service de cardiologie du Centre Hospitalier Universitaire la Référence Nationale (CHU-RN). MÉTHODES: Il s'est agi d'une étude transversale descriptive menée de Janvier 2017 à Décembre 2019 sur une série consécutive des patients hospitalisés pour péricardite liquidienne dans le service de cardiologie du Centre Hospitalier Universitaire la Référence Nationale de N'Djamena. RÉSULTATS: Durant la période d'étude, 1805 patients étaient hospitalisés dans le service de cardiologie dont 78 pour une péricardite liquidienne ; soit une prévalence de 4,3%. L'âge moyen était de 35,84 ± 14 ans, [extrêmes 16 et 73 ans]. Le sex-ratio était de 0,89. La dyspnée d'effort, la douleur thoracique, l'altération de l'état général et la fièvre étaient les maitres symptômes dans respectivement 90%, 89%, 81% et 51% des cas. Le frottement péricardique a été retrouvé chez 51% des patients. La sérologie VIH était positive chez 18 patients (26%) et 97% des patients avaient une cardiomégalie. A l'ECG, on retrouvait un micro voltage et des troubles diffus de la repolarisation dans respectivement 97% et 96% des cas. L'épanchement péricardique était majoritairement (57%) de grande abondance à l'échocardiographie. Les étiologies prédominantes étaient la tuberculose dans 47% des cas, une cause idiopathique dans 21% et une infection virale (VIH) dans 13%. Trente patients (43%) avaient bénéficié d'une ponction péricardique. Le taux de mortalité de la péricardite liquidienne était de 17%. CONCLUSION: la péricardite liquidienne est une pathologie fréquente, grave et mortelle au Tchad. Le traitement dépend de l'étiologie qui est dominée par la tuberculose.

Couverture vaccinale et raisons de l'acceptation et de l'hésitation à la vaccination contre la COVID-19 chez les patients porteurs de pathologie cardiovasculaire à Ouahigouya / Vaccination coverage and reasons for accept ance orhesitation in vaccination against COVI D-19 in patients with cardiovascular disease in Ouahigouya

Objectif. La pandémie de COVID-19 a été cause d'une mortalité élevée chez les patients porteurs de comorbidités comme les pathologies cardiovasculaires. L'accélération de la mise sur marché des vaccins contre la pandémie a suscité une réticence envers ces derniers. L'étudié porte sur l'attitude des patients porteurs de pathologie cardiovasculaires vus en consultation cardiologique à Ouahigouya vis-à-vis de la vaccination contre la COVID-19. Population et méthodes. Une étude transversale a été menée du 1er au 25 avril 2022 dans trois cliniques privées de la ville de Ouahigouya. Nous avons inclus les patients consentants et porteurs de pathologie cardiovasculaire vus en consultation cardiologique. Le questionnaire était centré sur les connaissances, attitudes et pratiques de groupe vis-à-vis de la vaccination, notamment les raisons de 'l'acceptation ou du refus de se faire vacciner. Résultats. Cent-un patients ont été interviewés. Le sex-ratio était 1,46 avec un âge moyen de 48,26 ± 11,93 ans. Les plus représentés étaient les travailleurs indépendants, les urbains, les musulmans, les non-scolarisés et les mariés. L'HTA et ses complications étaient les atteintes cardiovasculaires les plus fréquentes (93,07%). La proportion de vaccinés était de 55,45%. Les raisons les plus évoquées par les vaccinés pour se vacciner étaient pour se protéger (100%) et le suivi des Recommandations gouvernementales et des agents respectivement 78,52% et 72,21%. Les raisons de l'hésitation vaccinale les plus citées étaient : la COVID-19 est une maladie banale (62,22%) et la peur des effets secondaires (44,44%). Conclusion. La vaccination contre la COVID-19 devrait se poursuivre, accompagnée d'une sensibilisation efficace afin d'améliorer le taux de couverture vaccinale parmi les patients porteurs de pathologies cardiovasculaires

Objective. COVID-19 pandemic has caused high mortality in patients with comorbidities such as cardiovascular pathologies. The acceleration of the marketing of vaccines against the pandemic has caused reluctance towards them. The study focuses on the attitude of patients with cardiovascular disease seen in cardiology consultation in Ouahigouya vis-à-vis COVID-19 vaccination. Population and methods. A cross-sectional study was conducted from April 1 to 25, 2022 in three private clinics of the city of Ouahigouya. We included consenting patients and carriers of cardiovascular pathology seen in cardiology consultation. Our main data of interest were the knowledge, attitude and practice of this population towards vaccination, especially thereasons for accepting or refusing vaccination. Results One hundred and one patients were interviewed. The sex ratio was 1.46 with an average age of 48.26 ± 11.93 years. The most represented were the self-employed, urban dwellers, Muslims, the uneducated and the married. Hypertension and its complications were the most common cardiovascular disorders (93.07%). The proportion of vaccinated was 55.45%. The reasons most mentioned by the vaccinated for getting vaccinated were to protect themselves (100%) and to follow government recommendations and agents, respectively 78.52% and 72.21%. The most cited reasons for vaccine hesitation were: COVID-19 is a common disease (62.22%) and fear of side effects (44.44%). Conclusion. Vaccination against COVID-19 must continue, accompanied by effective awareness-raising in order to improve the vaccination coverage rate among patients with cardiovascular pathologies

[Evaluation of the quality-of-life of patients with pacemakers : experience of Burkina Faso about 120 patients paired with the collaboration of doctors from AUVERGNE (France)]. / Évaluation de la qualité de vie des patients porteurs d'un stimulateur cardiaque (pacemaker) : expérience du Burkina Faso à propos de 120 patients appareillés avec la collaboration des médecins d'Auvergne (France).

INTRODUCTION: In Burkina Faso, cardiac stimulation was introduced in October 2000 has grown over time.In orderto evaluate the effectiveness of stimulation on life, we proposed to evaluate the quality of life of patients with a pacemaker. GENERAL OBJECTIVE: to study the effect of the pacemaker on the quality of life of patients PATIENTS AND METHODS: This was a cross-sectional study aimed at describingthe wearers of a pacemaker for at least six months at the Yalgado OUEDRAOGO University Hospital and the Schiphramedical center.The AQUAREL questionnaire has been adapted to our context to establish a quality-of-life score. RESULTS: The mean age of the study population was 68 years with a female predominance (53.3%). Complete atrioventricular block was the main indication of stimulation in 55%. The average duration of implantation was 41.6 months with extremes of 8 and 128 months. The primo implantation was found in 79.1 % of patients against 18.3 % for a first change of case and2.5 % for a second change of housing. Double chamber stimulation was performed in 65% of cases. DDD mode was the most used followed by VVIR. The average quality of life score was 90.12. Negative predictors of quality of life were age and female.A correlation between quality-of-life score and age, hypertension and dyslipidemia was found (p< 0.05). On the other hand, no correlation between the number of implantation, the duration of implantation and the mode of stimulation was found (p> 0.05). CONCLUSION: patients with a pacemaker have a good quality of life. However, quality-of-life is not correlated with the number of pacemakers, nor the duration and mode of stimulation.

[Cardio-Renal Syndrome In Patients Hospitalized In The Cardiology Department Of The University Hospital Center Yalgado OUEDRAOGO (CHUYO): Epidemiology, Clinic, Paraclinic And Course's Aspects]. / Le Syndrome Cardio-Renal Dans Le Service De Cardiologie Du Centre Hospitalier Universitaire Yalgado OUEDRAOGO (CHU-YO) : Aspects Epidemiologiques, Cliniques, Para-Cliniques Et Evolutifs.

OBJECTIVE: The objective of this work was to study cardio-renal syndrome in patients hospitalized in the cardiology department of the University Hospital Center Yalgado OUEDRAOGO (CHUYO). PATIENTS AND METHODS: This was a retrospective, descriptive study for a period of three years, from 1st January 2010 to 31st December 2012. The study incorporated patients with associated signs of Heart Failure (HF) and Renal Insufficiency (RI). Sociodemographic, clinical and paraclinical parameters were considered in the study. We evaluated the value of creatinine clearance at admission and its progress during the hospitalization until patients were discharged. RESULTS: Sample group of 119 patients over the period; the prevalence of the syndrome cardio-renal (CRF) was 10.93%. The mean age of our patients was 52.6 ± 16.6 years. (extremes: 15-85 years). The sex ratio was 1.33. Our patients' medical histories were dominated by high blood pressure (58.8%) and hypertensive heart disease (33.6%). Dyspnea was the major functional sign in our study (84.9%). Left heart failure syndrome (LHFS) was the most frequently encountered clinical picture (91.3%). The mean value of the creatinine clearance at baseline was 41.5 ± 24.3 mL/min/1.73m2. The signs ECGs and Doppler echocardiograms were those of underlying heart disease: the hypertensive heart disease. An abdominal-pelvic ultrasound found a bilateral kidney failure in 65.7% cases. The average length of hospitalization was 17.7 ± 17.5 days. Death occurred in 19.5% cases. CONCLUSION: The prevalence of CRS was high in the CHU-YO. The prognosis was largely influenced by whether it was an acute or chronic kidney failure. Emphasis should be placed on primary prevention of CRS, early diagnosis and etiology of renal failure.

OBJECTIF: L'objectif de ce travail était d'étudier du syndrome cardio-rénal chez des malades hospitalisés dans le service de cardiologie du CHUYO. PATIENTS ET MÉTHODES: Il s'est agi d'une étude rétrospective à visée descriptive sur une période de trois ans allant du 1er janvier 2010 au 31 décembre 2012. Ont été inclus les dossiers de malades ayant des signes d'Insuffisance Cardiaque (IC) associés une Insuffisance Rénale (IR). Les paramètres sociodémographiques, cliniques et para-cliniques ont été étudiés. Nous avons évalué la valeur de la clairance de la créatinine à l'entrée et son évolution au cours de l'hospitalisation jusqu'à la sortie des patients. RÉSULTATS: Ainsi, nous avons retenu 119 sur la période; la prévalence du syndrome cardio-rénal (SCR) était de 10,93%. L'âge moyen de nos patients était de 52,6 ± 16,6 ans (extrêmes : 15-85 ans). Le sex-ratio était de 1,33. Les antécédents de nos patients étaient dominés par l'hypertension artérielle (58,8%) et les cardiopathies hypertensives (33,6%). La dyspnée constituait le signe fonctionnel majeur dans notre étude (84,9%). Le syndrome d'insuffisance cardiaque gauche (ICG) constituait le tableau clinique le plus fréquemment rencontré (91,3%). La valeur moyenne de la clairance de la créatininémie à l'entrée était de 41,5 ± 24,3 ml/min/1,73m2. Les signes ECG et échocardiographies Doppler étaient ceux de la cardiopathie sous jacente : la cardiopathie hypertensive. Une échographie abdomino-pelvienne retrouvait une souffrance rénale bilatérale dans 65,7% des cas. La durée d'hospitalisation moyenne était de 17,7 ± 17,5 jours. Le décès est survenu dans 19,5% des cas. CONCLUSION: La prévalence du SCR était élevée dans le service de cardiologie du CHU-YO. Son pronostic était largement influencé par le caractère aigu ou chronique de l'insuffisance rénale. L'accent doit être mis sur la prévention primaire du SCR, le diagnostic précoce et étiologique de l'insuffisance rénale.

Hypertensive crises in sub-Saharan Africa: Clinical profile and short-term outcome in the medical emergencies department of a national referral hospital in Burkina Faso.

BACKGROUND: Data on hypertensive crises (HC) are limited in sub-Saharan Africa (SSA). We aimed to characterize the pattern and short-term mortality of hypertensive emergencies (HE) and urgencies (HU). METHODS: This was a prospective cohort study. Consecutive patients with acute and severely elevated blood pressure (systolic>180mmHg and/or diastolic >120mmHg) with or without acute target-organs damage attending the emergency department (ED) of the Teaching Hospital of Yalgado Ouedraogo, Ouagadougou, Burkina Faso were included with a one-month follow-up. RESULTS: One hundred and sixty-six of 1254 patients presenting to the ED (January to march 2016) had HC (13.2%) and 113 of them (68.1%) had HE. The mean age was 50.9±15.9 years and males were 63.3% (n=105). Younger age (<45 years) accounted for 55% of the cases. History of known HTN was reported in 101 patients (60.8%). Among patients with HE, 62.8% had brain-related events, 30.1% had cardiac involvement and 31% had acute renal impairment. The overall survival rate was 89% within the first 72hours and 81% at fourteen days follow-up. At one-month follow-up, 36 patients died with a survival rate of 77.8%. Factors independently associated with death were history of known hypertension, acute brain-related damage and renal dysfunction and not being transferred to a specialized department. CONCLUSION: HC are not rare in SSA and are associated with higher morbidity and mortality in HE. Further studies are needed to determine factors that promote HC in African patients in order to better address the prevention and management strategies of such hypertensive entity.

[High performance athlete's heart: Results of a cross-sectional survey conducted in Bobo-Dioulasso, Burkina Faso]. / Le cœur d'athlète de haut niveau d'entraînement : résultats d'une enquête transversale menée à Bobo-Dioulasso, Burkina Faso.

PURPOSE OF THE STUDY: To describe the clinical, electrocardiographic and echocardiographic features of the athlete's heart. PATIENTS AND METHODS: This was a cross-sectional study conducted from August 2015 to February 2016 in the city of Bobo-Dioulasso in Burkina Faso. Athletes of high level of training (at least 8hours of weekly training, for more than six months regardless of the type of sport) have benefited from: a clinical examination, an electrocardiography and a cardiac ultrasound rest to look for electrical, morphological and functional cardiac changes. RESULTS: The 192 athletes with an athlete heart included had a median age of 24 years (IQI: 21-27). The median seniority in high performance sport was 6 years (IQI: 4-8) and 10hours weekly training sessions (IQI: 10-10). The consumption of tobacco, alcohol, tea/coffee, medicines and/or energy drinks was reported respectively in 4.2%, 7.3%, 99.0%, 53.4%. A history of exertional discomfort was reported by 4.7 athletes. Electrical modifications were present in 92.1%. Sinus bradycardia was the most common abnormality (75.0% of cases). The prevalence of left atrium dilatation and left ventricular dilation was 72.4 and 22.4%, respectively. That of left ventricular hypertrophy was 9.0%. CONCLUSION: In the high-performance athlete, the prevalence of electrical, morphological and functional changes was high. These need to be known by practitioners to differentiate them from cardiac pathology.

[Evolution profiles of acute coronary syndromes and GRACE, TIMI and SRI risk scores in Burkina Faso. A monocentric study of 111 patients]. / Profils évolutifs des syndromes coronaires aigus et scores de risque GRACE, TIMI et SRI au Burkina Faso. À propos d'une série monocentrique de 111 patients.

OBJECTIVES: The aims of this study was to assess evolution profile of acute coronary syndrome (ACS) based on risk level by GRACE, TIMI and SRI scores in the cardiology department, Yalgado Ouedraogo university hospital. PATIENTS AND METHODS: This was a prospective study of 111 consecutive patients admitted for ACS (mean age 57.61 years, 77.5% male) between January 1st and 2010 to May 31st 2015 in the department of cardiology. For each patient, risk scores were calculated and they were divided into risk group. Global survival at one month was described by Kaplan Meier method and prognostic factors were analyzed by multivariable Cox regression. RESULTS: The prevalence of ACS was 4.2%. Patients were admitted for ST-elevation ACS and non-ST-elevation ACS in 88.3% and 11.7%, respectively. Nineteen patients (17.1%) were admitted before the 12th hour. Hospital mortality was 8.1% and increased to 16.2% in one month. After risk stratification, one-month survival of patients with high risk, was shorter than patients at low-risk regardless of the score GRACE (log-rank=9.93, P=0.007), TIMI (log-rank=14.91, P=0.001) and SRI (log-rank=10.01, P=0.006). GRACE score (HR=1.01; P=0.002), TIMI (HR=1.33; P=0.01) and SRI (HR=1.02; P=0.01) were major prognostic factors for overall survival. CONCLUSION: ACS remains a serious disease with high morbidity and mortality in the days following the initial accident. These risk scores are applicable tools in Burkina Faso as evidenced statistic C (GRACE=0.75, TIMI=0.78 and SRI=0.74).

[Assessment of medical management of heart failure at National Hospital Blaise COMPAORE]. / Évaluation de la prise en charge médicale de l'insuffisance cardiaque à l'hôpital national Blaise COMPAORE.

AIM: The aim of this study was to assess the quality of medical management of heart failure at the National Hospital Blaise Compaoré according to the international guidelines. PATIENTS AND METHODS: A retrospective study was performed including consecutive patients admitted for heart failure documented sonographically from October 2012 to March 2015 in the Medicine and Medical Specialties Department of National Hospital Blaise Compaore with a minimum follow-up of six weeks. Data analysis was made by the SPSS 20.0 software. RESULTS: Eighty-four patients, mean age of 57.61±18.24 years, were included. It was an acute heart failure in 84.5% of patients with systolic left ventricular function impaired (77.4%). The rate of prescription of different drugs in heart failure any type was 88.1% for loop diuretics; 77.1% for angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and 65.5% for betablockers. In patients with systolic dysfunction, 84.62% of patients were received the combination of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and 75.38% for betablockers. Exercise rehabilitation was undergoing in 10.7% of patients. The death rate was 16.7% and hospital readmission rate of 16.7%. CONCLUSION: The prescription rate of major heart failure drugs is satisfactory. Cardiac rehabilitation should be developed.

[Management and prognosis of pulmonary embolism associated with right heart thrombi: A prospective study at the University Hospital Yalgado Ouédraogo]. / Prise en charge et pronostic des embolies pulmonaires associées à des thrombi intracavitaires droits : à propos d'une série prospective au centre Hospitalier Universitaire Yalgado Ouédraogo.

OBJECTIVE: To describe the management and evolution of high risk of death pulmonary embolism associated with right heart thrombi. MATERIAL AND METHODS: We conducted a prospective cohort survey over a 54 month-period, from March 1st, 2012 to September 30th 2015. Were included all patients with pulmonary embolism and having high or intermediate-high risk of death. Patients were divided into two groups according to whether cardiac Doppler-echography found a thrombus in the right chambers or not (ICT+ vs. ICT-). The survival curves for the patients were obtained using the software STATA. RESULTS: The prevalence of pulmonary embolism associated with right heart thrombi was 4% in our study. Thrombi were mobile, straight localization in all cases. The ICT+group was characterized by a significantly higher proportion of congestive heart and chronic lung disease. The proportion of patients' thrombolysis was significantly higher in the ICT-group. In the ICT+group, thrombolysis significantly reduced mortality giving a 30-day survival of 80% against 20% among patients receiving only heparin. CONCLUSION: Pulmonary embolism associated with right heart thrombi including the atrium are not exceptional. These patients are at high risk of early death. Thrombolysis is significantly improving the mortality of pulmonary embolism associated with right-sided heart thrombi.

[Five years assessment of cardiac stimulation in two public hospitals in Burkina Faso: An experiment of collaboration with two hospitals in Auvergne]. / Bilan de cinq ans de stimulation cardiaque dans deux structures hospitalières publiques du Burkina Faso : expérience d'une collaboration avec deux centres hospitaliers d'Auvergne.

OBJECTIVES: Cardiac stimulation becomes a reality in Burkina Faso. The aim of our study was to evaluate this activity over five years and to appreciate the impact of collaboration with French hospitals of Auvergne area in its development. MATERIALS AND METHODS: Prospective study including consecutively patients who underwent pacemaker implantation since June 2011. Data collected included indications, time to care, type of stimulation, complications, cost of treatment, and education and quality of life of the patient. RESULTS: Sixty-nine patients received definitive pacemaker from June 2011 to June 2016, of whom 45.5% were women. The mean age was 69 years (extremes 35 to 89s). Almost all patients (94%) were symptomatic (54% syncope and 30% dizziness and lipothymias). The main indication for definitive cardiac pacing was complete atrioventricular block of degenerative origin (83%). The mean time between indication and surgery was 8.2 days, and only 4% of patients received temporary stimulation. The lack of financial support was the main reason for the delay in taking charge. During the study period, the two health centers received support in the form of stimulation equipment, a technical platform, and regular training and practical training. This collaboration made it possible to overcome the lack of material, human and financial resources. We recorded as complications a case of case exteriorization, two cases of benign local hematoma and two cases of probe displacement. The quality of life of the patients improved markedly, none of patients undergoing surgery remained symptomatic. CONCLUSION: The organization of cardiac stimulation in Burkina Faso is a reality. Efforts must be made to sustain the activity and strengthen collaboration with hospitals in the north.

Complications aiguës de l'infarctus du myocarde (IDM) en milieu hospitalier universitaire au Burkina Faso : Profil et implications en santé publique

l'infarctus du myocarde (idM) constitue une urgence cardiologique absolue. Peu d'études ont été réalisées sur les complications précoces de cette affection au Burkina Faso. le but de ce travail était de décrire les aspects épidémiologiques, et évolutifs des complications aiguës de l'infarctus du myocarde dans le service de cardiologie du Chu Yo et d'entrevoir les implications en santé publique. il s'est agi d'une étude rétrospective sur une période de cinq (05) ans allant du 1er Janvier 2010 au 31 décembre 2014, portant sur les dossiers médicaux des patients hospitalisés dans le service pour syndrome coronarien aigu confirmé par l'eCg de surface et le dosage de la troponine sérique (SCa ST+ Troponine+). durant cette période, 2 469 patients ont été hospitalisés dans le service dont 102 pour infarctus du myocarde ST+, soit une prévalence hospitalière de 4,1 %. Quatre et vingt (80) patients étaient de sexe masculin contre 22 de sexe féminin, soit un sexe ratio homme/Femme de 3,6. l'âge moyen de nos patients était de 57 ans avec des extrêmes de 21 et 90 ans. l'hTa et l'obésité étaient les facteurs de risque modifiables les plus rencontrés avec respectivement 57,7 % (n= 58) et 29,7 % (n = 21). la grande majorité de nos patients (74,8 % (n = 76)) résidait en zone urbaine, et 84,3 % (n = 90) de nos patients avaient été hospitalisés dans le service après la 12e heure du début de la douleur. a l'électrocardiogramme de surface (eCg), les atteintes du territoire antérieur étaient le plus retrouvées, suivi de celles des territoires inférieur et antéro-septal avec respectivement 25,2 % ; 23,4 %. Soixante de nos patients (58,8 % des cas) avaient présenté des complications précoces, dominées par les complications hémodynamiques (37,2 %), rythmiques (25,5 %) et thromboemboliques (14,7 %). la thrombolyse à la streptokinase n'a pu être réalisée que chez 08 patients (7,8 %). nous avons enregistré 11,7 % (12) cas de décès. l'infarctus du myocarde est une urgence cardiovasculaire absolue avec la possibilité de survenue de complications surtout à la phase aiguë de la maladie. il s'agit complications en lien avec le retard de consultation des patients. Pour éviter les conséquences socio-économiques suite à l'idM, il importe de réduire les facteurs de risque cardiovasculaire modifiables et à réorganiser les services de santé pour y faire face avec une offre de soins et services de santé conséquente à tous les niveaux du système de santé

Affections cardio-vasculaires et l'infection à VIH en milieu hospitalier universitaire au Burkina Faso : profil épidémiologique, clinique et évolutif, et implications en santé publique

Le Syndrome immunodéficitaire acquis (Sida) constitue l'une des épidémies les plus meurtrières de l'histoire de l'humanité. l'avènement des médicaments antirétroviraux(aRV) en modifiant l'histoire naturelle de la maladie, par l'amélioration de la survie des patients, les exposeraient à l'émergence des pathologies cardiovasculaires. Ce travail avait pour objectif de décrire les aspects épidémiologique, clinique, paraclinique et évolutif des affections cardio-vasculaires au cours de l'infection à Vih, et entrevoir les implications en santé publique. il s'est agi d'une étude rétrospective réalisée du 01 Janvier 2011 au 31 mars 2015, elle a inclus 91 patients Vih recrutés au Centre hospitalier universitaire Yalgado ouédraogo de ouagadougou, présentant des anomalies cliniques et/ou des facteurs de risque cardiovasculaires (FdRCV) évoquant une maladie cardiovasculaire. un bilan cardiologique était réalisé en vue d'une confirmation. l'âge moyen des patients ayant présenté une pathologie cardiovasculaire associant l'infection au Vih était de 45 ± 10 ans avec les extrêmes de 20 et de 83 ans. il y avait 53 femmes (58,24 %) pour un sexe ratio homme / femme de 0,7. les sujets du niveau socio- économique faible étaient les plus représentés avec une fréquence de 56 % des cas. le tableau clinique cardiovasculaire était dominé par l'insuffisance cardiaque globale (28,57 %). les signes majeurs étaient la dyspnée, la douleur précordiale, la toux, la tachycardie et la grosse jambe douloureuse. les manifestations cardiovasculaires étaient diverses, les maladies thromboemboliques (48,35 %) étaient les plus représentées. les atteintes myocardiques (17,59 %), les atteintes péricardiques (15,39 %) et les atteintes de l'endocarde (12,09 %) étaient notées en leurs proportions respectives. il est ressorti que 3,30 % des patients ont présenté un infarctus du myocarde chez des patients vivant avec le Vih (PVVih) sous traitement antirétroviral (aRV). la mortalité hospitalière était de 14,29 %. au vu de leur fréquence, de leur taux de décès et pour leur prise en charge précoce, les atteintes cardiovasculaires au cours de l'infection par le Vih seraient multiformes. une bonne connaissance de la question par le personnel médical et paramédical et une prise en charge précoce contribuerait à la réduction de létalité y afférente

Facteurs associés à l'équilibre du traitement antivitamine K au Centre Hospitalier Universitaire Yalgado Ouedraogo de Ouagadougou (Burkina Faso)

Objectif : Cette étude avait pour objectif d'étudier les facteurs associés à l'équilibre du traitement antivitamine K(AVK) chez les patients suivis au service de cardiologie du CHU-YO.Méthodologie : Il s'agit d'une étude rétrospective à visée analytique qui a recensé pendant une période de 3 mois les patients sous traitement AVK dans le service de cardiologie du CHU-YO. N'ont pas été inclus les patients dont les résultats des contrôles INR des 3 derniers mois ne figuraient pas dans le carnet de suivi. Le logiciel Epi info version 3.5 a servi à l'analyse statistique et le test de Khi2 à la comparaison au seuil de 0,05.Résultats : Nous avons colligé 193 patients. L'âge moyen était de 53 ans avec des extrêmes entre 14 et 95 ans. L'INR était stable dans 40% des cas et un accident hémorragique sous AVK a été observé dans 12%. Il y avait une prédominance non-significative de la proportion d'INR stable chez les patients qui avaient la possibilité de réaliser l'examen en leur lieu de résidence (40,7% vs 37,7%). La proportion d'INR stable était plus élevée chez les patients qui avaient un niveau d'instruction inférieur au secondaire (43% vs 35%) sans association statistique significative (p = 0,60). La proportion d'INR stable était plus élevée chez les patients sous traitement depuis au moins un an (45% vs 35%) sans association significative (p = 0,06). Les comorbidités ont été retrouvées dans 14% des cas sans association statistique avec la survenue d'un événement hémorragique. Le régime alimentaire pauvre en vitamine K a été institué chez 86% des patients, mais sans corrélation avec la stabilité de l'INR. Le bon niveau d'éducation thérapeutique était significativement associé au bon équilibre du traitement aux AVK (P = 0,0002). Conclusion : La qualité de l'éducation thérapeutique est l'élément clé du bon équilibre du traitement AVK au CHU-YO, d'où l'intérêt d'y mettre l'accent

[Severe pulmonary embolism and acute lower limb ischemia complicating peripartum cardiomyopathy successfully treated by streptokinase]. / Embolie pulmonaire grave et ischémie aiguë de membre inférieur compliquant une cardiomyopathie du péripartum traitées avec succès par thrombolyse à la streptokinase.

Peripartum cardiomyopathy is a cardiac disease at high thromboembolism potential. The authors report a case of peripartum cardiomyopathy admitted for congestive heart failure. Echocardiography found a dilated cardiomyopathy with severely impaired left ventricular systolic function and biventricular thrombi. During hospitalization his condition was complicated by severe bilateral pulmonary embolism and left lower limb arterial acute thrombosis. The treatment consisted of thrombolysis with streptokinase associated with dobutamine (in addition to the conventional treatment of heart failure and bromocriptine). The outcome was favorable, marked by pulmonary and lower limb arterial unblocking.

Isolated aortic valvular and pulmonary involvement during essential eosinophilia.

Endomyocardial fibrosis is the most classic and the most known complication of prolonged hypereosinophilic syndrome, whatever the cause. In Burkina Faso, this complication is most frequently encountered in idiopathic form of the syndrome. It commonly involves the apex of the ventricles with possible involvement of atrioventricular valves. The clinical picture is that of restrictive cardiomyopathy with poor prognosis. We report the case of a 22-year-old man with atypical cardiac involvement during idiopathic hypereosinophilic syndrome. Echocardiographic examination showed isolated aortic valve involvement. Left and right ventricular function was preserved. The apex of ventricles was free of lesion. Pulmonary CT-scan showed massive bilateral lung involvement. Treatment consisted of strict control of the eosinophilic process and pulmonary management. The patient suddenly died sudden pulmonary distress one month after first being seen.

[Evaluation of the knowledge of patients about the management of treatment with anti-vitamin K drugs in the Service of Cardiology of Ouagadougou]. / Évaluation du niveau de connaissance des patients sur la gestion du traitement par les antivitamines K dans le service de cardiologie de Ouagadougou.

INTRODUCTION: Vitamin K antagonists (VKA), the most widely prescribed oral anticoagulant therapy, represent a major public health problem by the adverse events related to their use. The aim of this study was to clarify the level of knowledge that patients have about the management of their oral anticoagulant treatment. PATIENTS AND METHODS: This was a descriptive cross-sectional study performed at Yalgado Ouedraogo university Hospital, over a period of three months starting from March 1st to May 31st 2012. A questionnaire was given to patients receiving VKA treatment for at least a month. RESULTS: Seventy patients were enrolled in the study of which 30 men. The median age was 49±16 years. Heart disease and venous thromboembolic disease justifying the introduction of VKA treatment were found respectively in 58.6 and 41.4% of the cases. The name of the VKA and the exact reason for the treatment were known respectively in 91.4 and 61.7% of the case. More than half of patients (68.6%) knew that the VKA makes blood more fluid. Forty-six patients (65.7%) cited INR as biological monitoring of treatment but only 28 patients (40%) were aware of INR target values. The majority of patients did not know the risks in case of overdose (72.8%) and underdosing (71.4%). Self-medication by non-steroidal anti-inflammatory drugs was reported by 18 patients (25.7%). Cabbage (74.3%) and lettuce (62.9%) were the main foods reported to be consumed moderately. CONCLUSION: The knowledge of patients on the management of VKA is fragmentary and remains insufficient to ensure the effectiveness of the treatment. The creation of a therapeutic education program is then necessary.

[Neurological complications of infective endocarditis in Burkina Faso. Clinical features, management and evolutionary profile]. / Les complications neurologiques des endocardites infectieuses au Burkina Faso. Caractéristiques cliniques, prise en charge et profil évolutif.

INTRODUCTION: Neurological complications are the most frequent extracardiac complications of infective endocarditis (IE). This study aimed to describe the epidemiological, clinical and paraclinical aspects, and outcome of neurological complications of infective endocarditis in three hospitals in the city of Ouagadougou in Burkina Faso. PATIENTS AND METHOD: From 1 January 2009 to 31 December 2012, we included all patients suffering from IE and selected those in whom a neurological complication was objectified. Neurological involvement was sought on clinical examination but especially CT brain (ischemic infarcts, hemorrhages, aneurysms and abscesses). Blood cultures were systematic. Echocardiography was done for vegetations and characteristics. RESULTS: Among 63 cases of IE, neurological complications were found in 14 patients (22.2%). The average age of patients with neurological complications was 37.4 ± 5.8 years. The sex ratio was 1.3 for women. Neurological damage consisted of nine cases of stroke (64.3%), three cases of hemorrhagic stroke (21.4%) and two cases of brain abscess (14.3%). Neurological complications had already occurred before hospitalization in 4 cases. Blood cultures were positive in 8 cases. Germs found were predominantly Staphylococcus aureus (5 cases) and Streptococcus a- viridans (2 cases). All cases of S. aureus were complicated by stroke. At echocardiography, vegetation was found in all cases. It was found on the mitral in 7 cases, the aorta in 3 cases, the mitral and aortic in 2 cases and the mitral and tricuspid in 2 cases also. The EI had occurred on a native valve in 11 cases, prosthesis in 4 cases (2 mitral and 2 aortic). The vegetations average diameter was 11.2 ± 2.1 mm (6.4 and 1 7.7 mm). Vegetations were mobile in 12 cases. The treatment consisted of antibiotics adapted to the antibiogram, neurological and cardiovascular monitoring. The evolution was marked by seven deaths (50%), including 5 deaths related to cerebral complication (71.4% of deaths). CONCLUSION: This study shows that neurological complications during infective endocarditis are frequent, dominated by stroke with a high mortality.

[Super hypertension in cardiology department in Burkina Faso]. / La super hypertension artérielle en milieu cardiologique au Burkina Faso.

Super hypertension is defined as systolic BP ≥ 250mmHg and/or diastolic BP ≥ 150mmHg in presence or not of complications. The aim of our study was to describe the epidemiological and evolutive patterns of super hypertension in the cardiology department of the Yalgado Ouedraogo University Hospital. It was an observation cohort over a period of 26 months (July 2011 to August 2013). We recruited 34 patients, corresponding to a prevalence of 12.9% of all hypertensive patients. The median time of follow-up was 7.1 months. The mean age was 47 years old, with a sex-ratio of 1.3. Twenty-one (62%) of the patients were known hypertensive, out of who 24% were regularly rewiewed, 57% on treatment, but none was on regular medications. Dyspnoea was the reason for consulting in 38% of the cases. We noticed a fundoscopy stage III or IV in 55.9% of the cases. All patients had left ventricular hypertrophy on ECG, and 90% on echocardiography. Complication was noticed on admission in 91% of the cases. Chronic renal failure occured in 14.7% of the cases during follow-up, and overall mortality rate was 0.5 person years. Probability of survival over one month was 70% for all patients. The mean age of deceased was 35%. Presence of renal failure, unknown hypertension, and age<45 were factors linked to death (P<0.05). Super hypertension is a pathology of the youth, with high morbi-mortality. The prevention is done through early detection and efficient management of hypertension.