[Double thrombosis of left cardiac cavities: report of a case seen at the CHU Campus in Lome]. / Double thrombose des cavites cardiaques gauches: a propos d'un cas observe au CHU-Campus de Lome.

We report an observation of a double left thrombosis intraventriculaire and atrium at a subject 45 years. The diagnosis was made by the transthoracic two-dimensional echocardiography which showed a dilated cardiomyopathy and two bulky thrombi in the left ventricle and atrium. As the chirurgical treatment is not accessible, we use the medical treatment: anticoagulant treatment associated on the low salt diet, with diuretic and the inhibitors of the enzyme of conversion, the evolution was favourable without embolic accident.

[Ischemic cardiomyopathy in Lome: epidemiologic aspects and risk factors (study of 461 cases)]. / Les cardiopathies ischemiques (CI) à Lomé: aspects épidémiologiques et facteurs de risque (etude de 461 cas).

UNLABELLED: According to the WHO, cardiovascular disease such as arterial hypertension and ischemic heart disease will be the main non-communicable diseases in developing countries in the next decades. In Togo, there is no statistic on this disease on this day. Our objectives were to study the epidemiological aspects and to describe the risk factors of this affection in our surroundings. It is about a multicentric transverse study from June 1st, 2004 to May 31, 2007, in 3 sanitary formations of the city of Lomé. RESULTS: The frequency of ischemic heart disease was 11, 46%. There was a feminine predominance with a sex-ratio of 0.71. The average age of the patients was about 55.3 +/- 13.4 years with extremes of 18 and 95 years. The cardiovascular risk factors were: dyslipidaemia (76.9%), hypertension (75.3%), left ventricular hypertrophy (72.8%), abdominal obesity (71.1%), hyperuricemia (50.5%), hyperglycemia (41.9%) of which overt diabetes (29%) and smoking (3%). There was a feminine predominance at the hypertensive and the obese. The women accumulated more modifiable risk factors than the men. The middle risk indication was of 2.34 +/- 0.9 at the men and 2.55 +/- 0.8 at the women. The different clinical forms were: stable angina (71.2%), unstable angina (1.7%) and myocardial infarction (5.2%); silent ischemia represented 21.9%. The antero-septal territory was the more reached in case of myocardial infarction and the antero-lateral territory in case of ischemia. CONCLUSION: A sanitary politic centered on the eviction of the risk factors should help to reduce the prevalence of this affection for a long time in our surroundings.

Double thrombose des cavites cardiaques gauches : a propos d'un cas observe au CHU - Campus de Lome. Cas clinique

Nous rapportons une observation d'une double thrombose du ventricule gauche et de l'oreillette gauche chez un sujet de 45 ans. Le diagnostic a ete realise grace a une echo-graphie bidimensionnelle Transthoracique qui a mis en evidence un aspect de cardiomyopathie dilatee hypokinetique ainsi que deux volumineux thrombus; l'un tapissant a la pointe du ventricule gauche et l'autre flottant dans la cavite de l'oreillette gauche. Le traitement chirurgical etant inaccessible; un traitement medical a ete institue : anticoa-gulant associe au repos; au regime desode; aux diuretiques; et aux inhibiteurs de l'enzyme de conversion. L'evolution a court terme a ete favorable; sans accident embolique. Mais le pronostic a long terme est reserve et depend de la cardiomyopathie elle-meme