[Characteristics of effusive pericarditis in N'Djamena (Chad)]

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.

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.

[Evaluation of the knowledge of patients about the management of treatment with anti-vitamin K drugs in the Service of Cardiology of 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.

[Super hypertension in cardiology department in 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.