1
|
Kerrouani O, Faraj R, Bouchaala A, Dib H, Lahmouch N, Bargach I, Kihoul O, Zarzur J, Cherti M. Severe familial coronary artery spasm in 2 siblings: About 2 cases. Radiol Case Rep 2023; 18:4374-4379. [PMID: 37840889 PMCID: PMC10568283 DOI: 10.1016/j.radcr.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 08/26/2023] [Accepted: 09/01/2023] [Indexed: 10/17/2023] Open
Abstract
Vasospastic angina is the spasm of coronary arteries causing transient myocardial ischemia. VSA is commonly managed with antispasmodic medications including calcium-channel blockers and nitrates. When vasospasm is refractory to conventional medications, unconventional treatment modalities may be used for symptomatic relief. Coronary artery spasm was observed in 2 sisters. Neither of them had significant atheromatous stenosis in the coronary arteries. The 22-year younger sister presented with rest angina in the early morning. The 32-year-old elder sister complained of rest and effort angina. Their coronary angiogram showed spontaneous spasm in the proximal segment of the left anterior descending coronary artery. The youngest one had resistant and recurrent coronary vasospasm involving different segments of the coronary tree causing myocardial infarction with total occlusion of the proximal segment in the left anterior descending coronary artery. Our patients presented with a lesser-known phenomenon called refractory VSA, where intermittent vasospasm continues despite being on a combination of 2 medications. The familial appearance of coronary artery spasm had been previously reported. Although it is not well understood, the underlying mechanism appears to involve a combination of endothelial damage and vasoactive mediators. Genetic factors such as human leucocyte antigen contribute to susceptibility to coronary spasm in some patients with VSA. Treatment for VSA is well documented; however, little data is available for refractory VSA.
Collapse
Affiliation(s)
- Oualid Kerrouani
- Mohammed V University, Rabat, Morocco
- Cardiology B Department, Ibn Sina University Hospital center, Rabat, Morocco
| | - Raid Faraj
- Mohammed V University, Rabat, Morocco
- Cardiology B Department, Ibn Sina University Hospital center, Rabat, Morocco
| | - Abderrahmane Bouchaala
- Mohammed V University, Rabat, Morocco
- Cardiology B Department, Ibn Sina University Hospital center, Rabat, Morocco
| | - Hassan Dib
- Mohammed V University, Rabat, Morocco
- Cardiology B Department, Ibn Sina University Hospital center, Rabat, Morocco
| | - Nouhaila Lahmouch
- Mohammed V University, Rabat, Morocco
- Cardiology B Department, Ibn Sina University Hospital center, Rabat, Morocco
| | - Iness Bargach
- Mohammed V University, Rabat, Morocco
- Cardiology B Department, Ibn Sina University Hospital center, Rabat, Morocco
| | - Ouassima Kihoul
- Mohammed V University, Rabat, Morocco
- Cardiology B Department, Ibn Sina University Hospital center, Rabat, Morocco
| | - Jamila Zarzur
- Mohammed V University, Rabat, Morocco
- Cardiology B Department, Ibn Sina University Hospital center, Rabat, Morocco
| | - Mohamed Cherti
- Mohammed V University, Rabat, Morocco
- Cardiology B Department, Ibn Sina University Hospital center, Rabat, Morocco
| |
Collapse
|
2
|
El Ouartassi H, El Boussaadani B, Faraj R, Fellat I, Cherti M. Three-Dimensional (3D) Mapping and Catheter Ablation for Simultaneous Reverse Typical and Atypical Atrial Flutter: A Case Report. Cureus 2023; 15:e48948. [PMID: 38106800 PMCID: PMC10725656 DOI: 10.7759/cureus.48948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2023] [Indexed: 12/19/2023] Open
Abstract
Atrial flutter, a common cardiac arrhythmia, is characterized by rapid and regular atrial contractions that result in a characteristic sawtooth pattern on the electrocardiogram. It emerges due to the formation of reentrant electrical circuits within the atria, giving rise to structured, sawtooth-patterned atrial waves as observed on electrocardiography. We present the case of a 52-year-old female with a medical history of ankylosing spondylitis, dyslipidemia, and a previous surgical closure of an atrial septal defect. The patient developed a rare form of atrial flutter, characterized by two distinct mechanisms: a clockwise isthmus-dependent flutter and an atypical scar-related flutter around the atriotomy scar. In order to effectively address this complex condition, a successful ablation procedure was performed to target both mechanisms. This case report offers valuable insights into the complexities surrounding the diagnosis and treatment of a complex case characterized by the coexistence of multiple mechanisms of atrial flutter within a single patient. While catheter ablation has demonstrated improved success rates for typical and atypical atrial flutters when occurring in isolation, predicting the prognosis of complex cases continues to pose challenges.
Collapse
Affiliation(s)
| | - Badre El Boussaadani
- Cardiology, Centre Hospitalier Universitaire (CHU) Mohammed VI - Tanger, Tanger, MAR
| | - Raid Faraj
- Cardiology, Ibn Sina University Hospital Center, Rabat, MAR
- Cardiology, Mohammed V University, Rabat, MAR
| | - Ibtissam Fellat
- Cardiology, Ibn Sina University Hospital Center, Rabat, MAR
- Cardiology, Mohammed V University, Rabat, MAR
| | - Mohamed Cherti
- Cardiology, Mohamed V University, Rabat, MAR
- Cardiology, Ibn Sina University Hospital Center, Rabat, MAR
| |
Collapse
|
3
|
Walid BB, Reda L, Zakaria C, Fatima Azzahra B, Oukerraj L, Cherti M. Overcoming Technical Complexities in Late Coronary Stent Thrombosis: A Clinical Report. Cureus 2023; 15:e47448. [PMID: 38021508 PMCID: PMC10660386 DOI: 10.7759/cureus.47448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2023] [Indexed: 12/01/2023] Open
Abstract
Complex bifurcation lesions often requiring a two-stent revascularization approach mean more metal, a higher risk of major adverse cardiovascular events, and added difficulties in the case of late complications, such as in-stent restenosis and stent thrombosis. In this article, we report a case of late stent thrombosis in a 56-year-old patient who had left main (LM) and left anterior descending (LAD) left circumflex arteries with T and small protrusion technique percutaneous intervention (PCI) one year before her admission with hemodynamic compromise and no access to urgent coronary artery bypass grafting (CABG). We discuss challenging and high-risk PCI with limited resources, and the result was satisfactory with a favorable outcome. Stent thrombosis, a critical and life-threatening complication of PCI, frequently manifests with ST-elevation myocardial infarction, carrying a high mortality risk. Known risk factors for stent thrombosis include stent underexpansion, inadequate lesion preparation, complex percutaneous procedures, and early discontinuation of dual antiplatelet therapy. The choice of revascularization strategy is crucial, particularly for patients with extensive coronary artery disease, where surgery allows for a more complete revascularization. Coronary angioplasty is a pleasing and less invasive technique, but it requires proper lesion preparation, optimization of stent deployment through intracoronary imaging, post-dilation, and, most importantly, adherence and proper use of antithrombotic treatment following guidelines and medical therapy, which remains the cornerstone of managing ischemic heart disease.
Collapse
Affiliation(s)
- Ben Brahim Walid
- Department of Cardiology B, Centre Hospitalo-Universitaire (CHU) Ibn Sina, Rabat, MAR
| | - Lahjouji Reda
- Department of Cardiology B, Centre Hospitalo-Universitaire (CHU) Ibn Sina, Rabat, MAR
| | - Choho Zakaria
- Department of Cardiology B, Centre Hospitalo-Universitaire (CHU) Ibn Sina, Rabat, MAR
| | | | - Latifa Oukerraj
- Department of Cardiology B, Centre Hospitalo-Universitaire (CHU) Ibn Sina, Mohammed V University, Rabat, MAR
| | - Mohamed Cherti
- Department of Cardiology B, Centre Hospitalo-Universitaire (CHU) Ibn Sina, Mohammed V University, Rabat, MAR
| |
Collapse
|
4
|
El Ouartassi H, Faraj R, Laraichi Z, Ezzahraoui R, Bourouhou Z, Doghmi N, Cherti M. Biventricular arrhythmogenic cardiomyopathy diagnosed in a young patient: A case report with literature review. Radiol Case Rep 2023; 18:3248-3251. [PMID: 37520387 PMCID: PMC10375373 DOI: 10.1016/j.radcr.2023.06.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 06/13/2023] [Accepted: 06/16/2023] [Indexed: 08/01/2023] Open
Abstract
Arrhythmogenic cardiomyopathy is a genetic heart muscle disease that typically affects the right ventricle. However, 2 other phenotypes affecting the left ventricle were recently discovered. Here, we report the case of an 18-year-old patient with biventricular arrhythmogenic cardiomyopathy, highlighting the challenges encountered in establishing this diagnosis. Diagnostic criteria for the left-sided phenotypic variants of arrhythmogenic cardiomyopathy were only introduced in 2020 by an international expert consensus document, known as the "Padua criteria," they are divided in 6 categories with an emphasis on morpho-functional ventricular abnormalities and structural myocardial tissue alterations to diagnose biventricular arrhythmogenic cardiomyopathy.
Collapse
Affiliation(s)
- Hajar El Ouartassi
- Cardiology B Department, Ibn Sina University Hospital Center, Rabat, Morocco
- Mohammed V university Rabat
| | - Raid Faraj
- Cardiology B Department, Ibn Sina University Hospital Center, Rabat, Morocco
- Mohammed V university Rabat
| | - Zakariae Laraichi
- Cardiology B Department, Ibn Sina University Hospital Center, Rabat, Morocco
- Mohammed V university Rabat
| | - Rhita Ezzahraoui
- Cardiology B Department, Ibn Sina University Hospital Center, Rabat, Morocco
- Mohammed V university Rabat
| | - Zaineb Bourouhou
- Cardiology B Department, Ibn Sina University Hospital Center, Rabat, Morocco
- Mohammed V university Rabat
| | - Nawal Doghmi
- Cardiology B Department, Ibn Sina University Hospital Center, Rabat, Morocco
- Mohammed V university Rabat
| | - Mohamed Cherti
- Cardiology B Department, Ibn Sina University Hospital Center, Rabat, Morocco
- Mohammed V university Rabat
| |
Collapse
|
5
|
Mesfioui MB, Belharty N, Mesfioui Y, Doghmi N, Cherti M. Pericardial Decompression Syndrome and an Evanescent Tricuspid Regurgitation: A Real Conundrum. Cureus 2023; 15:e45571. [PMID: 37868463 PMCID: PMC10586887 DOI: 10.7759/cureus.45571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2023] [Indexed: 10/24/2023] Open
Abstract
Cardiac tamponade is a life-threatening condition that requires emergency pericardiocentesis. In rare cases, pericardial drainage may be followed by "pericardial decompression syndrome" (PDS), a poorly understood but potentially fatal syndrome characterized by acute ventricular dysfunction. It may present in different clinical forms of varying severity and be managed differently depending on the clinical context. In this article, we report an atypical presentation of this syndrome, with the development of laminar tricuspid regurgitation after pericardial drainage. To our knowledge, this complication has never been reported in the medical literature. Our understanding of the pathophysiology of this condition is based entirely on case reports. And because clinical studies are difficult to perform, the best defense against PDS is early detection so that it can be recognized and treated quickly.
Collapse
Affiliation(s)
| | - Najlaa Belharty
- Cardiology B Department, Ibn Sina University Hospital, Mohammed V University, Rabat, MAR
| | - Yousra Mesfioui
- Cardiology B Department, Ibn Sina University Hospital, Mohammed V University, Rabat, MAR
| | - Nawal Doghmi
- Cardiology B Department, Ibn Sina University Hospital, Mohammed V University, Rabat, MAR
| | - Mohamed Cherti
- Cardiology B Department, Ibn Sina University Hospital, Mohammed V University, Rabat, MAR
| |
Collapse
|
6
|
Soufiani A, Chraibi H, Asfalou I, Ouafi NE, Hattaoui ME, Habbal R, Chaib A, Fellat R, Akoudad H, Benyass A, Cherti M, Abouqal R, Bendagha N, Ztot S. The national moroccan registry of ST-elevation myocardial infarction (MR-MI). BMC Cardiovasc Disord 2023; 23:419. [PMID: 37620762 PMCID: PMC10464033 DOI: 10.1186/s12872-023-03458-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/19/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND MR-MI is the first national Moroccan ST-elevation myocardial infarction (STEMI) registry. Its objectives are to assess patient management modalities and highlight the clinical and therapeutic characteristics of this pathology in all cardiology centres on a national scale. METHODS Adult patients presenting with STEMI within 5 days of symptoms onset were enrolled over a period of 18 weeks from April to August 2018. 57 cardiology centres distributed in 22 cities in Morocco participated in the study, including 5 university hospitals, representing 70% of Moroccan centres managing STEMI patients. A case report form was sent to the investigators in both electronic and paper forms. Sociodemographic, clinical, management, revascularization, and follow-up data were collected. RESULTS A total of 809 patients were recruited. The population was mostly male (74.8%) with an average age of 62.6 ± 11.6 years. The most common risk factors were smoking (38.3%) arterial hypertension (30.7%), and diabetes (28%). 30% of patients were admitted within the first 6 h of symptoms onset and early revascularization was performed on 49.6%. Mortality rate was 5.2% in-hospital and 3.2% at the one-month follow-up. CONCLUSION MR-MI is the first Moroccan STEMI registry on a national scale. Relevant management delays are much longer than other countries, and less than 50% of the patients that present on time benefit from early revascularization. Efforts remain to be done on the optimal diagnosis and treatment of STEMI.
Collapse
Affiliation(s)
- Aida Soufiani
- Cardiology A Department, Ibn Sina Hospital University Centre, Mohammed V University, Rabat, Morocco
| | - Hamza Chraibi
- Cardiology A Department, Ibn Sina Hospital University Centre, Mohammed V University, Rabat, Morocco.
| | - Ilyasse Asfalou
- Cardiology Department, Mohammed V Military Instruction Hospital, Mohammed V University, Rabat, Morocco
| | - Noha El Ouafi
- Cardiology Department, Mohammed VI Hospital University Centre, Mohamed Premier University, Oujda, Morocco
| | - Mustapha El Hattaoui
- Cardiology Department, Mohammed VI Hospital University Centre, Cadi Ayyad University, Marrakesh, Morocco
| | - Rachida Habbal
- Cardiology Department, Ibn Rochd Hospital University Centre, Hassan II University, Casablanca, Morocco
| | - Ali Chaib
- Cardiology Department, Mohammed V Military Instruction Hospital, Mohammed V University, Rabat, Morocco
| | - Rokya Fellat
- Cardiology A Department, Ibn Sina Hospital University Centre, Mohammed V University, Rabat, Morocco
| | - Hafid Akoudad
- Cardiology Department, Hassan II Hospital University Centre, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Aatif Benyass
- Cardiology Department, Mohammed V Military Instruction Hospital, Mohammed V University, Rabat, Morocco
| | - Mohamed Cherti
- Cardiology B Department, Ibn Sina Hospital University Centre, Mohammed V University, Rabat, Morocco
| | - Redouane Abouqal
- Medical Emergencies Department, Ibn Sina Hospital University Centre, Mohammed V University, Rabat, Morocco
| | - Nesma Bendagha
- Cardiology A Department, Ibn Sina Hospital University Centre, Mohammed V University, Rabat, Morocco
| | - Samir Ztot
- Cardiology Department, Mohammed V Military Instruction Hospital, Mohammed V University, Rabat, Morocco
| |
Collapse
|
7
|
Belharty N, Siagh S, El Ghali T, Doghmi N, Cherti M. Marfan Syndrome, Giant Ascending Aortic Aneurysm, and Left Ventricular Noncompaction: The Heart in Jeopardy! Cureus 2023; 15:e44117. [PMID: 37750108 PMCID: PMC10518205 DOI: 10.7759/cureus.44117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 09/27/2023] Open
Abstract
Marfan syndrome (MFS) is a heritable connective tissue disorder that is caused by a mutation of the FBN1 gene. It is characterized by cardiovascular, skeletal, and ocular manifestations, with thoracic aortic aneurysms being the main cardiovascular complication. Unconventionally, MFS can present with left ventricular noncompaction (LVNC), which introduces a supplementary aspect of cardiac dysfunction. We herein report the case of a 42-year-old male with MFS who presented with congestive heart failure and cardiogenic shock. His transthoracic echocardiography revealed a giant aortic root aneurysm, causing severe aortic regurgitation and dilated cardiomyopathy, along with LVNC. This case provides a brief overview of this rare medical condition, particularly the natural history of ascending thoracic aortic aneurysm, which is considered a silent complication and the most life-threatening one, combined with LVNC that correspondingly impairs the heart.
Collapse
Affiliation(s)
- Najlaa Belharty
- Department of Cardiology B, Ibn Sina Hospital, Mohammed V University, Rabat, MAR
| | - Selma Siagh
- Department of Cardiology B, Ibn Sina Hospital, Mohammed V University, Rabat, MAR
| | - Tanae El Ghali
- Department of Cardiology B, Ibn Sina Hospital, Mohammed V University, Rabat, MAR
| | - Nawal Doghmi
- Department of Cardiology B, Ibn Sina Hospital, Mohammed V University, Rabat, MAR
| | - Mohamed Cherti
- Department of Cardiology B, Ibn Sina Hospital, Mohammed V University, Rabat, MAR
| |
Collapse
|
8
|
Faraj R, Diallo TH, Dib H, Sarsari M, Diafarou R, Zarzur J, Cherti M. Mechanical prosthetic mitral valve obstruction: Pannus or thrombus? A case report. Radiol Case Rep 2023; 18:2685-2688. [PMID: 37293521 PMCID: PMC10245095 DOI: 10.1016/j.radcr.2023.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/01/2023] [Accepted: 05/04/2023] [Indexed: 06/10/2023] Open
Abstract
Substitution of a defective heart valve with a prosthetic heart valve turns the native disease for prosthesis-related complications. One of the most serious and dreaded complications is prosthetic valve obstruction. It is either the result of a thrombus or pannus formation. For the evaluation of prosthetic valve obstruction, transthoracic echography and fluoroscopy provide functional information but may not provide information about the etiology of the obstruction, unlike multidetector computed tomography (MDCT) which allows a more precise etiological diagnosis to guide the therapeutic attitude. Here, we report a case of a mechanical prosthetic mitral valve obstruction in a 45-year-old patient in whom the diagnosis of pannus was retained on the basis of clinical, biological, and imaging data. The differentiation between thrombus and pannus is crucial because it conditions the therapeutic attitude. Advanced imaging specially MDCT options should be considered whenever mechanical prosthesis valve obstruction is suspected.
Collapse
Affiliation(s)
- Raid Faraj
- Mohammed V University, Rabat, Morocco
- Cardiology B department, Ibn Sina university hospital center, Rabat, Morocco
| | - Thierno Hamidou Diallo
- Mohammed V University, Rabat, Morocco
- Cardiology B department, Ibn Sina university hospital center, Rabat, Morocco
| | - Hassan Dib
- Mohammed V University, Rabat, Morocco
- Cardiology Center, Mohammed V Military Instruction Hospital of Rabat, Morocco
| | - Mohamed Sarsari
- Mohammed V University, Rabat, Morocco
- Cardiology B department, Ibn Sina university hospital center, Rabat, Morocco
| | - Raynatou Diafarou
- Mohammed V University, Rabat, Morocco
- Cardiology B department, Ibn Sina university hospital center, Rabat, Morocco
| | - Jamila Zarzur
- Mohammed V University, Rabat, Morocco
- Cardiology B department, Ibn Sina university hospital center, Rabat, Morocco
| | - Mohamed Cherti
- Mohammed V University, Rabat, Morocco
- Cardiology B department, Ibn Sina university hospital center, Rabat, Morocco
| |
Collapse
|
9
|
Belharty N, El Ghali T, Siagh S, Choho Z, Benmessaoud FA, Fellat I, Oukerraj L, Cherti M. Post-Myocardial Revascularization: As a Nidus for an Electrical Storm! Cureus 2023; 15:e43450. [PMID: 37711947 PMCID: PMC10498482 DOI: 10.7759/cureus.43450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2023] [Indexed: 09/16/2023] Open
Abstract
Electrical storm (ES) is a critical and potentially life-threatening cardiac rhythm disorder. It is characterized by the presence of three or more distinct episodes of sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) that necessitate appropriate termination. ES may occur in the setting of acute myocardial infarction or following myocardial reperfusion. An urgent treatment approach is necessary for better outcomes. We represent a case of a 64-year-old patient who presented with sudden chest pain and an episode of palpitations related to non-ST elevation myocardial infarction (NSTEMI), who has undergone percutaneous coronary intervention of the stenotic epicardial artery, but subsequently experienced an ES in the absence of stent thrombosis. ES presented in the form of sustained monomorphic VT that required synchronous direct current cardioversion, anti-arrhythmic drugs, deep sedation, and endotracheal intubation with a favorable course, with the patient being discharged after 14 days hospital stay. The practitioner should be mindful of the potential occurrence of ES following myocardial revascularization and should tailor the management approach.
Collapse
Affiliation(s)
- Najlaa Belharty
- Department of Cardiology B, Ibn Sina Hospital, Mohammed V University, Rabat, MAR
| | - Tanae El Ghali
- Department of Cardiology B, Ibn Sina Hospital, Mohammed V University, Rabat, MAR
| | - Selma Siagh
- Department of Cardiology B, Ibn Sina Hospital, Mohammed V University, Rabat, MAR
| | - Zakaria Choho
- Department of Cardiology B, Ibn Sina Hospital, Mohammed V University, Rabat, MAR
| | | | - Ibtissam Fellat
- Department of Cardiology B, Ibn Sina Hospital, Mohammed V University, Rabat, MAR
| | - Latifa Oukerraj
- Department of Cardiology B, Ibn Sina Hospital, Mohammed V University, Rabat, MAR
| | - Mohamed Cherti
- Department of Cardiology B, Ibn Sina Hospital, Mohammed V University, Rabat, MAR
| |
Collapse
|
10
|
Faraj R, Dib H, Abdelali M, Zarzur J, Cherti M. Post-cardiac injury syndrome due to iatrogenic injury successfully managed medically: a case report. J Med Case Rep 2023; 17:277. [PMID: 37394431 DOI: 10.1186/s13256-023-04010-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 05/26/2023] [Indexed: 07/04/2023] Open
Abstract
BACKGROUND Coronary artery perforation is a rare but serious complication of percutaneous coronary interventions, that may eventually lead to major and fatal events such as myocardial infarction, cardiac tamponade, and ultimately death. The risk of coronary artery perforation is more significant during complex procedures as chronic total occlusions but it can occur in other circumstances such as oversized stents and/or balloons, excessive post-dilatation, and the use of hydrophilic wires. Coronary artery perforation is often not recognized during the procedure and the diagnosis is frequently not made until later when the patient develops signs related to pericardial effusion. Thus, causing a delay in management and worsening the prognosis. CASE PRESENTATION We report a case of a distal coronary artery perforation secondary to using a hydrophilic guide in a young male patient of 52-year-old arab, initially presented with an ST-segment elevation myocardial infarction, complicated by pericardial effusion that was treated medically with a favorable outcome. CONCLUSIONS This work highlights that coronary artery perforation is a complication that must be anticipated in high-risk situations and its diagnosis must be made early to allow adequate management.
Collapse
Affiliation(s)
- Raid Faraj
- Mohammed V University, Rabat, Morocco.
- Department of Cardiology B, Ibn Sina University Hospital Center, Rabat, Morocco.
| | - Hassan Dib
- Mohammed V University, Rabat, Morocco
- Department of Cardiology B, Ibn Sina University Hospital Center, Rabat, Morocco
| | - Mehdi Abdelali
- Mohammed V University, Rabat, Morocco
- Cardiology Center, Mohammed V Military Instruction Hospital, Rabat, Morocco
| | - Jamila Zarzur
- Mohammed V University, Rabat, Morocco
- Department of Cardiology B, Ibn Sina University Hospital Center, Rabat, Morocco
| | - Mohamed Cherti
- Mohammed V University, Rabat, Morocco
- Department of Cardiology B, Ibn Sina University Hospital Center, Rabat, Morocco
| |
Collapse
|
11
|
Belharty N, Elharrak M, Ziani G, El Ghali T, Cherti M. Late Identification of a Stealthy Aorto-Pulmonary Window: A Case Report. Cureus 2023; 15:e42524. [PMID: 37637538 PMCID: PMC10457545 DOI: 10.7759/cureus.42524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2023] [Indexed: 08/29/2023] Open
Abstract
The term "aortopulmonary window" (APW), often referred to as "aortopulmonary septal defect," refers to a rare congenital medical disorder where there is an improper direct link between the main pulmonary artery and the ascending aorta. It can be combined with other cardiac congenital conditions or be an isolated lesion. Herein, we report the incidental discovery of a minor, restrictive aortopulmonary septal defect in a 60-year-old male who denied having any clinical symptoms. Incidentally detected APW in adulthood is uncommon and, hence, can be readily overlooked, a fortiori, in asymptomatic patients.
Collapse
Affiliation(s)
- Najlaa Belharty
- Department of Cardiology B, Ibn Sina Hospital, Mohammed V University, Rabat, MAR
| | - Meriem Elharrak
- Department of Cardiology B, Ibn Sina Hospital, Mohammed V University, Rabat, MAR
| | - Ghizlan Ziani
- Department of Cardiology B, Ibn Sina Hospital, Mohammed V University, Rabat, MAR
| | - Tanae El Ghali
- Department of Cardiology B, Ibn Sina Hospital, Mohammed V University, Rabat, MAR
| | - Mohamed Cherti
- Department of Cardiology B, Ibn Sina Hospital, Mohammed V University, Rabat, MAR
| |
Collapse
|
12
|
El Ouartassi H, El Boussaadani B, Faraj R, Fellat I, Cherti M. Unmasking Idiopathic Brugada ECG Pattern: Inducible Type 1 Brugada Pattern in a Young Patient and Clinical Implications. Cureus 2023; 15:e40739. [PMID: 37485210 PMCID: PMC10361336 DOI: 10.7759/cureus.40739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2023] [Indexed: 07/25/2023] Open
Abstract
Brugada syndrome is a rare inherited channelopathy associated with an increased risk of ventricular tachycardia and ventricular fibrillation, leading to syncope and sudden cardiac death. We present a case report of a young patient with an inducible type 1 Brugada pattern on an electrocardiogram (ECG), accompanied by a comprehensive literature review. The 19-year-old patient presented with dizziness and exhibited a type 2 Brugada pattern on admission ECG, which converted to a type 1 pattern following an Ajmaline test. Based on the absence of symptoms, inducible arrhythmias, or cardiac events in the patient's history, implantable cardioverter-defibrillator insertion was deemed unnecessary. Genetic testing was recommended, and screening ECGs were advised for the patient's first-degree relatives. The discussion explores the different types of Brugada patterns, their diagnostic significance, and the controversies surrounding risk stratification and management strategies. The case underscores the importance of maintaining clinical suspicion for Brugada syndrome in young patients and tailoring treatment approaches based on individual characteristics and risk factors.
Collapse
Affiliation(s)
- Hajar El Ouartassi
- Cardiology, Ibn Sina University Hospital Center/Mohammed V University Rabat, Rabat, MAR
| | - Badre El Boussaadani
- Cardiology, Mohammed VI University Hospital Center of Tangier/Abdelmalek Essaadi University, Tangier, MAR
| | - Raid Faraj
- Cardiology, Ibn Sina University Hospital Center/Mohammed V University Rabat, Rabat, MAR
| | - Ibtissam Fellat
- Cardiology, Ibn Sina University Hospital Center/Mohammed V University Rabat, Rabat, MAR
| | - Mohamed Cherti
- Cardiology, Ibn Sina University Hospital Center/Mohammed V University Rabat, Rabat, MAR
| |
Collapse
|
13
|
Diallo TH, Faraj R, Hilal S, Lahraoui M, Kisra O, Benmessaoud FA, Doghmi N, Fellat I, Cherti M. Pre-excited atrial fibrillation revealed at a very delayed age: case report. Int J Emerg Med 2023; 16:34. [PMID: 37170212 PMCID: PMC10173537 DOI: 10.1186/s12245-023-00506-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 05/03/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Wolff-Parkinson-White (WPW) syndrome is a condition characterized by the persistence of an accessory pathway responsible for ventricular pre-excitation that can lead to symptomatic and potentially severe arrhythmias. Coexistence with atrial fibrillation is well known and not uncommon, exposing to potential degenerescence into ventricular fibrillation when atrial impulses are transmitted along the accessory pathway. WPW syndrome is most prevalent in younger patients and cases revealed after an advanced age have rarely been described in the literature. CASE PRESENTATION Here, we report a case of atrial pre-excitation first diagnosed at the age of 72 years that required external electrical cardioversion with a favorable outcome. The diagnosis was based on clinical and electrographic findings. CONCLUSIONS WPW syndrome is a relatively rare cardiac disorder that can be a cause of sudden death, especially when combined with atrial fibrillation. Therefore, cardiologists have to consider this diagnosis in patients presenting clinical signs of arrhythmia with an electrical pattern of WPW.
Collapse
Affiliation(s)
- Thierno Hamidou Diallo
- Clinical cardiology department, Cardiology Center, Mohammed V Military Instruction Hospital of Rabat, Mohammed V University, Rabat, Morocco
| | - Raid Faraj
- Cardiology B department, Ibn Sina University Hospital of Rabat, Mohammed V University, Rabat, Morocco.
| | - Safae Hilal
- Cardiology B department, Ibn Sina University Hospital of Rabat, Mohammed V University, Rabat, Morocco
| | - Myriam Lahraoui
- Cardiology B department, Ibn Sina University Hospital of Rabat, Mohammed V University, Rabat, Morocco
| | - Oualid Kisra
- Cardiology B department, Ibn Sina University Hospital of Rabat, Mohammed V University, Rabat, Morocco
| | | | - Nawal Doghmi
- Cardiology B department, Ibn Sina University Hospital of Rabat, Mohammed V University, Rabat, Morocco
| | - Ibtissam Fellat
- Cardiology B department, Ibn Sina University Hospital of Rabat, Mohammed V University, Rabat, Morocco
| | - Mohamed Cherti
- Cardiology B department, Ibn Sina University Hospital of Rabat, Mohammed V University, Rabat, Morocco
| |
Collapse
|
14
|
Belharty N, Fertat O, El Ghali T, Tabti F, Benmessaoud FA, Oukerraj L, Cherti M. Ectatic Coronary Arteries: Diversity at Its Finest. Cureus 2023; 15:e38381. [PMID: 37265918 PMCID: PMC10231275 DOI: 10.7759/cureus.38381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2023] [Indexed: 06/03/2023] Open
Abstract
Coronary artery ectasia (CAE) is an entity causing inappropriate dilatation of the coronary tree, that is angiographically defined, albeit arbitrarily, by the diameter of the ectatic segment being more than 1.5 times larger in comparison with an adjacent healthy reference segment. Although the causative mechanisms are poorly understood, atherosclerosis is greatly implicated in the causation of CAE. Clinical, angiographic, and therapeutic features have been puzzling clinicians. We illustrate three different angiographic subsets, co-existing with myocardial bridge/coronary slow flow and diversely presenting as asymptomatic, pauci, and frankly symptomatic with stable and acute coronary syndrome. These cases illuminate the diversity of CAE's clinical and angiographic presentations and pathologic progression, shedding light on this medical condition and its implications.
Collapse
Affiliation(s)
- Najlaa Belharty
- Department of Cardiology B, Ibn Sina Hospital, Mohammed V University, Rabat, MAR
| | - Oumaima Fertat
- Department of Cardiology B, Ibn Sina Hospital, Mohammed V University, Rabat, MAR
| | - Tanae El Ghali
- Department of Cardiology B, Ibn Sina Hospital, Mohammed V University, Rabat, MAR
| | - Fatine Tabti
- Department of Cardiology B, Ibn Sina Hospital, Mohammed V University, Rabat, MAR
| | | | - Latifa Oukerraj
- Department of Cardiology B, Ibn Sina Hospital, Mohammed V University, Rabat, MAR
| | - Mohamed Cherti
- Department of Cardiology B, Ibn Sina Hospital, Mohammed V University, Rabat, MAR
| |
Collapse
|
15
|
Machraa A, Fertat O, Ben Brahim W, Oukerraj L, Cherti M. Multimodality Imaging Assessment of Ischemic-Related Submitral Left Ventricular Pouch: A Case Report. Cureus 2023; 15:e38575. [PMID: 37288231 PMCID: PMC10241659 DOI: 10.7759/cureus.38575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2023] [Indexed: 06/09/2023] Open
Abstract
Submitral left ventricular aneurysm remains a rare condition with a varied etiology besides the congenital origin. We describe the case of a 62-year-old male patient who presented, two weeks after an inferobasal myocardial infarction (MI), with dyspnea and atypical chest pain. Transthoracic echocardiography (TTE) and cardiac computed tomography (CT) revealed a giant thin-walled submitral left ventricular aneurysm. He was managed conservatively given the high operative risk. The overall survival was five months after discharge. Despite its rarity, recognizing the causal relationship between ischemic heart disease and submitral aneurysm can prevent life-threatening complications and is therefore of major importance. In the era of advanced imaging, multimodality cardiac imaging techniques are a key element for guiding diagnostic and therapeutic strategies.
Collapse
Affiliation(s)
- Achraf Machraa
- Department of Cardiology B, Ibn Sina University Hospital Center, Mohammed V University, Rabat, MAR
| | - Oumaima Fertat
- Department of Cardiology B, Ibn Sina University Hospital Center, Mohammed V University, Rabat, MAR
| | - Walid Ben Brahim
- Department of Cardiology B, Ibn Sina University Hospital Center, Mohammed V University, Rabat, MAR
| | - Latifa Oukerraj
- Department of Cardiology B, Ibn Sina University Hospital Center, Mohammed V University, Rabat, MAR
| | - Mohamed Cherti
- Department of Cardiology B, Ibn Sina University Hospital Center, Mohammed V University, Rabat, MAR
| |
Collapse
|
16
|
Faraj R, Dib H, Belhoussine H, Sarsari M, Lahjouji R, Bargach I, Zarzur J, Cherti M. Mitral valvar anomalies causing subaortic stenosis: two rare case reports. Ann Med Surg (Lond) 2023; 85:1108-1111. [PMID: 37113861 PMCID: PMC10129105 DOI: 10.1097/ms9.0000000000000365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 02/21/2023] [Indexed: 03/31/2023] Open
Abstract
Subaortic stenosis (SubAS) is a common cause of left ventricular outflow tract obstruction. It may be focal or diffuse, leading to the development of a subaortic tunnel. Considered for a long time as a congenital anomaly, SubAS has been established lately as an acquired anomaly and secondary to a pre-existing anatomic alteration in the interventricular septum and mitral valve apparatus. It is a progressive disease that is often confused with obstructive hypertrophic cardiomyopathy, which can lead to several complications. Case presentation In this paper, the authors report two cases of SubAS secondary to different mitral valvar anomalies. The analysis of echocardiographic data was a milestone in raising this diagnosis and identifying its mechanisms. Conclusion This work highlights a rare situation, often underdiagnosed, in which the evolution can be marked by an important risk of recurrence even after surgical cure.
Collapse
|
17
|
Chraibi H, Samih A, Lahmouch N, Zarzur J, Cherti M. Anomalous Left Main Coronary Artery From the Right Sinus of Valsalva. Cureus 2023; 15:e35709. [PMID: 37016639 PMCID: PMC10066849 DOI: 10.7759/cureus.35709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2023] [Indexed: 03/06/2023] Open
Abstract
Anomalous coronary arteries are rare, mostly benign anatomic abnormalities. Anomalous origin of the left main coronary artery from the right sinus of Valsalva (LCA-RSV) is a rare variant that may lead to myocardial ischemia or sudden cardiac death. We present the case of a 49-year-old patient with a history of type 2 diabetes and smoking who presented to the emergency department with acute chest pain and was diagnosed with inferior ST-elevation myocardial infarction (STEMI). A transthoracic echocardiogram demonstrated inferolateral wall motion abnormalities of the left ventricle. The patient underwent cardiac catheterization that showed an anomalous left main coronary artery originating from the right sinus of Valsalva, alongside atherosclerotic triple-vessel disease. He was discharged home on medical management, including dual antiplatelet therapy, beta blockers, and statins, with scheduled follow-up.
Collapse
|
18
|
Snoussi NEH, Serroukh Y, El Hattab FZ, Cherti M. Giant left atrial myxoma revealed by syncopal attacks. J Saudi Heart Assoc 2022; 34:113. [PMID: 35990313 PMCID: PMC9359130 DOI: 10.37616/2212-5043.1305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 05/27/2022] [Indexed: 11/25/2022] Open
Affiliation(s)
- Nour El Houda Snoussi
- Department of Cardiology B, Ibn Sina Hospital Center, Mohammed V University of Rabat,
Morocco
- Corresponding author at: Department of Cardiology B, Ibn Sina Hospital Center, Mohammed V University of Rabat, Appartement 10, Immeuble 25, Rue Jbel Bouiblane, Avenue Michlifen, Haut Agdal, Rabat, 10170, Morocco. E-mail address: (N.E.H. Snoussi)
| | - Youssra Serroukh
- Department of Cardiology B, Ibn Sina Hospital Center, Mohammed V University of Rabat,
Morocco
| | - Fatima-Zahra El Hattab
- Department of Cardiology B, Ibn Sina Hospital Center, Mohammed V University of Rabat,
Morocco
| | - Mohamed Cherti
- Department of Cardiology B, Ibn Sina Hospital Center, Mohammed V University of Rabat,
Morocco
| |
Collapse
|
19
|
Faraj R, Laktib N, Hilal S, Hassan F, Krimech A, Bouanani A, Sarsari M, Fellat I, Zarzur J, Cherti M. Systemic sclerosis and tachycardia-bradycardia syndrome: a case report. J Med Case Rep 2022; 16:258. [PMID: 35729641 PMCID: PMC9210766 DOI: 10.1186/s13256-022-03462-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 05/17/2022] [Indexed: 11/10/2022] Open
Abstract
Background Systemic sclerosis is a multisystemic character autoimmune disease. It is characterized by vascular dysfunction and progressive fibrosis affecting mainly the skin but also different internal organs. All heart structures are commonly affected, including the pericardium, myocardium, and conduction system. However, tachycardia–bradycardia syndrome is not common in the literature as a cardiac complication of systemic sclerosis. Case presentation We report a case of tachycardia–bradycardia syndrome in a 46-year-old Moroccan woman followed for systemic sclerosis with cutaneous, vascular, and articular manifestations. The diagnosis was based mainly on patient-reported symptoms and electrocardiogram data. A permanent pacemaker was implanted, allowing the introduction of beta-blockers with good outcomes. Conclusions This case aims to show that even minor electrocardiogram abnormalities should be monitored in this group of patients, preferably by 24-hour ambulatory electrocardiogram because they could be a good indicator of the activity and progression of cardiac fibrosis.
Collapse
Affiliation(s)
- Raid Faraj
- Mohammed V University of Rabat, Rabat, Morocco.
| | | | - Safae Hilal
- Mohammed V University of Rabat, Rabat, Morocco
| | | | | | | | | | | | | | | |
Collapse
|
20
|
Mesmoudi B, Samih A, Jennane R, Nguadi J, Doghmi N, Cherti M. Des lésions coronaires. Rev Med Interne 2022; 43:512-513. [DOI: 10.1016/j.revmed.2022.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 01/08/2022] [Accepted: 04/09/2022] [Indexed: 11/17/2022]
|
21
|
Faraj R, Bourouhou Z, Oussama S, Bouamoud A, Rami H, Samih A, Fellat I, Zarzur J, Cherti M. Accelerated junctional rhythm (AJR) revealing light-chain cardiac amyloidosis: A case report with literature review. Ann Med Surg (Lond) 2022; 75:103410. [PMID: 35386774 PMCID: PMC8977896 DOI: 10.1016/j.amsu.2022.103410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/15/2022] [Accepted: 02/23/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction and importance Cardiac amyloidosis (CA) is a rare condition, characterized by fibrillary proteins infiltration in the extracellular space of the heart. Even though many types of cardiac amyloidosis exist, light chain amyloidosis (AL) and transthyretin amyloidosis (ATTR) remain the most described forms. The diagnosis of amyloidosis represents a real challenge for clinicians, requiring both invasive and non-invasive investigations. Conduction defects and atrial arrhythmias are well known complications of cardiac amyloidosis. However, only a few studies have reported junctional rhythm a primary presentation of light chain cardiac amyloidosis (AL). An early diagnosis and proper management are crucial to improve the prognosis of this disease. Case presentation Here, we report a rare case of a 48 year-old patient, in acutely decompensated heart failure, presenting an accelerated junctional rhythm (AJR) as initial presentation of light-chain cardiac amyloidosis. The diagnosis was made based on clinical, biological, radiological and histological findings. This case shows diagnostic difficulties and management of this rare disease. Cardiac amyloidosis is a rare condition, characterized by fibrillary proteins infiltration in the extracellular space of the heart. Junctional rhythm a primary presentation of light chain cardiac amyloidosis (AL) is extremely rare. The association between cardiac AL amyloidosis and heart failure without etiologic treatment can be dramatic with an overall median survival of six months.
Collapse
|
22
|
Faraj R, Djibril A, Benmessaoud FA, Benasser M, Zarzur J, Oukerraj L, Amri R, Cherti M. Acute ST-elevation myocardial infarction (STEMI) in a young woman with unknown mitral stenosis and atrial fibrillation: Case report. Ann Med Surg (Lond) 2022; 75:103465. [PMID: 35386790 PMCID: PMC8978105 DOI: 10.1016/j.amsu.2022.103465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 02/26/2022] [Accepted: 02/28/2022] [Indexed: 11/28/2022] Open
Abstract
Introduction and importance Chronic rheumatic heart disease is the most common cause of mitral stenosis. It remains a major public health problem. In almost half of the cases, paroxysmal or chronic atrial fibrillation occurs during the evolution of mitral stenosis, thereby exposing to an increased risk of thrombo-embolic events. Whereas the most frequent site for embolism is the cerebral circulation, any organ may be involved, especially the coronary circulation, resulting in a myocardial infarction (MI). Case presentation Here, we report a rare case of a 50-year-old patient, with no risk factors for cardiovascular disease, presenting an acute ST-elevation myocardial infarction (STEMI) as initial presentation of unknown mitral stenosis with atrial fibrillation and strongly suggesting an embolic origin. The diagnosis was made based on the national cerebral and cardiovascular center (NCVC) criteria for the clinical diagnosis of coronary artery embolism (CE). Coronary angiography showed a distal thrombus in the right coronary artery that has been medically treated. The outcome was favorable and the patient was referred after that for mitral valve replacement. Coronary embolism (CE) is an uncommon and rare cause of acute coronary syndrome (ACS). Atrial fibrillation represents the most common cause of CE, followed by cardiomyopathy and valvular heart disease. Long term outcomes of STEMI patients related to CE are worst compared to STEMI patients non related to CE.
Collapse
|
23
|
Faraj R, Bachar A, Sidaty O, Bouamoud A, Fassi Fehri Z, Chrifi FZ, Chikhi F, Fellat I, Amri R, Cherti M. Complete heart block in a young adult with non-isolated congenitally corrected transposition of the great arteries: Case report. Ann Med Surg (Lond) 2022; 76:103500. [PMID: 35340322 PMCID: PMC8940947 DOI: 10.1016/j.amsu.2022.103500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction and importance Congenitally corrected transposition of the great arteries (ccTGA) or L-looped transposition of the great arteries (L-TGA) is a very rare and complex form of congenital heart disease. The majority of patients with ccTGA have at least one or more associated congenital heart disorders, essentially ventricular septal defects. Patients with ccTGA can remain asymptomatic for a long time and the diagnosis can sometimes be made late in life at the stage of complications. Case presentation Here, we report a rare case of a 19-year-old patient, with no medical or surgical history, presenting a complete heart block as initial presentation of a ‘’non-isolated’’ ccTGA. The diagnosis is made essentially by echocardiography. This case aims to show diagnostic difficulties of this rare congenital heart disease and be aware of the risk of its relative complications. Congenitally corrected transposition of the great arteries (ccTGA) is a very rare and complex form of congenital heart disease. Cardiac conduction disorders are well-established complications of ccTGA. The presence or absence of associated cardiac disorders is an important parameter to determinate the risk of chronic heart failure.
Collapse
|
24
|
Kharbouch H, Boussaadani B, Fellat I, Oukerraj L, Doghmi N, Cherti M. Kearns Sayre syndrome: a rare etiology of complete atrioventricular block in children (case report). Pan Afr Med J 2022; 40:154. [PMID: 34970396 PMCID: PMC8683484 DOI: 10.11604/pamj.2021.40.154.24281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 09/24/2021] [Indexed: 12/02/2022] Open
Abstract
Kearns Sayre syndrome is a rare mitochondrial abnormality first described in 1958, characterized by a triad associating progressive external ophthalmoplegia, ptosis, and pigmentary retinopathy with progressive alteration of cardiac conduction, which determines the vital prognosis of this entity. Here we report the case of a 13-year-old child of consanguineous parents who consults for recurrent syncope. The clinical exam found bilateral ptosis with complete atrioventricular block on electrocardiogram. The ophthalmological exam found pigmentary retinopathy. The patient underwent successful implantation of a double chamber pacemaker within 24 hours of admission, with an uneventful postoperative course. This case report highlights the interest of systematically assessing cardiac complications in children with mitochondrial disease such as Kearns Sayre syndrome, especially since cardiac involvement is the major prognostic factor in this disease.
Collapse
Affiliation(s)
- Hanane Kharbouch
- Cardiovascular Diseases B Department, Ibn Sina Medical Hospital, Mohamed V University, Rabat, Morocco
| | - Badr Boussaadani
- Cardiovascular Diseases B Department, Ibn Sina Medical Hospital, Mohamed V University, Rabat, Morocco
| | - Ibtissam Fellat
- Cardiovascular Diseases B Department, Ibn Sina Medical Hospital, Mohamed V University, Rabat, Morocco
| | - Latifa Oukerraj
- Cardiovascular Diseases B Department, Ibn Sina Medical Hospital, Mohamed V University, Rabat, Morocco
| | - Nawal Doghmi
- Cardiovascular Diseases B Department, Ibn Sina Medical Hospital, Mohamed V University, Rabat, Morocco
| | - Mohamed Cherti
- Cardiovascular Diseases B Department, Ibn Sina Medical Hospital, Mohamed V University, Rabat, Morocco
| |
Collapse
|
25
|
Faraj R, Bourouhou Z, Belhoussine H, Bouamoud A, Rami H, Cherti M. Postural instability revealing infective endocarditis secondary to severe mitral stenosis: A case report with literature review. Ann Med Surg (Lond) 2021; 72:103131. [PMID: 34925823 PMCID: PMC8649078 DOI: 10.1016/j.amsu.2021.103131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/23/2021] [Accepted: 11/30/2021] [Indexed: 11/22/2022] Open
Abstract
Introduction and importance Infective endocarditis is a severe infection of the endocardial surface of the heart. One or more heart valves can be infected. However infective endocarditis complicating mitral stenosis is rare. It can be revealed by several and various symptoms such as fever and cardiac murmurs but also by complications such as focal neurological complaints Case presentation We report a case of a febrile postural instability as the primary presentation of an infective endocarditis secondary to a severe mitral stenosis in a young patient with a history of mitral stenosis for which he benefited from percutaneous mitral dilation. The diagnosis was based on the modified Duke criteria. In this case, the treatment was based mainly on antibiotic therapy. The outcome was favorable; with a clinical, biological and radiological improvement. The patient was subsequently referred to the cardiovascular department for surgical treatment of his valve disease. Clinical discussion Rheumatic heart disease is the main cause of mitral stenosis and its prevalence is higher in developing nations than in the rest of the world, yet only few articles have reported infective endocarditis as a complication of mitral stenosis. Conclusion Mitral stenosis is rarely complicated by infective endocarditis, but this diagnosis should not be excluded in developing countries, particularly because of its high prevalence. To that end, clinicians should recognize its symptoms and complications and act accordingly to allow early treatment. Mitral stenosis is rarely complicated by infective endocarditis. Recognizing infective endocarditis at an early stage is essential. Antimicrobial therapy is the backbone therapy of infective endocarditis along with surgery management, in some cases of complicated IE.
Collapse
Affiliation(s)
- Raid Faraj
- Department of Cardiology B, CHU Ibn Sina, Rabat, Morocco
| | | | | | - Asmae Bouamoud
- Department of Cardiology B, CHU Ibn Sina, Rabat, Morocco
| | - Hasna Rami
- Department of Cardiology B, CHU Ibn Sina, Rabat, Morocco
| | - Mohamed Cherti
- Department of Cardiology B, CHU Ibn Sina, Rabat, Morocco
| |
Collapse
|
26
|
Haboub M, Mechal H, Cherti M, Doghmi N, Hattaoui M, Bendriss L, Khatouri A, Habbal R. Epidemiology and outcomes of chronic heart failure among Moroccan individuals: A multicentric study. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
27
|
El Boussaadani B, El Aissaoui A, Doghmi N, Cherti M. Left ventricular apical aneurysms complicating HCM: Clinical and paraclinical features, MRI semiology (about 7 cases with literature review). Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
28
|
Alaika O, Jamai S, Doghmi N, Cherti M. Diagnostic Accuracy of Global Longitudinal Strain for Detecting Significant Coronary Artery Disease in Diabetic Patients without Regional Wall Motion Abnormality. J Saudi Heart Assoc 2020; 32:425-433. [PMID: 33299787 PMCID: PMC7721456 DOI: 10.37616/2212-5043.1096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/25/2020] [Accepted: 08/31/2020] [Indexed: 11/20/2022] Open
Abstract
AIMS Speckle-tracking imaging is a novel method for assessing left ventricular (LV) function and ischemic changes. The aim of this prospective study was to assess the diagnostic accuracy of global longitudinal strain (GLS) and regional longitudinal strain (RLS) parameters at rest in comparison to stress echocardiography findings for detecting significant coronary artery disease (CAD) in patients with diabetes mellitus (DM). METHODS We prospectively studied echocardiographic characteristics at rest with Speckle tracking echocardiography (2D STE) measures; then stress echocardiography and coronary angiography data in 34 diabetic patients without regional wall motion abnormality (RWMA) at rest. Patients were grouped according to coronary angiography and stress echocardiography results into two groups CAD (+) vs control group CAD (-). RESULTS GLS at rest was lower in the CAD (+) group ((-14.2 % ± 3.1 vs -17.8 % ± 3.1 in the control group CAD (-), P=0.004). GLS at rest had the highest area under the ROC curve (AUC) (AUC 0.78, sensitivity 61%, specificity 91%,P=0.009) with the cut-off of -14.5% which is equal to predictive power of wall motion scoring index (WMSI) at peak stress to detect significant CAD (AUC=0.76 (95% CI 0.58-0.94, P= 0.016) with the cut-off value of 1.21). CONCLUSIONS Global longitudinal strain at rest by STE showed excellent specificity (>90%) and good sensitivity (60%) for the diagnosis of severe CAD among the diabetic population with unknown CAD. This is the first study showing that GLS at rest with cutoff value at -14.5% had good and equal diagnostic accuracy as WMSI at peak stress to detect significant CAD among the diabetic population.
Collapse
Affiliation(s)
- Oumaima Alaika
- Ibn Sina Hospital, Mohammed V University, Rabat, Morocco
| | - Souad Jamai
- Ibn Sina Hospital, Mohammed V University, Rabat, Morocco
| | - Nawal Doghmi
- Ibn Sina Hospital, Mohammed V University, Rabat, Morocco
| | - Mohamed Cherti
- Ibn Sina Hospital, Mohammed V University, Rabat, Morocco
| |
Collapse
|
29
|
Sasbou L, El boussaadani B, Fellat I, Cherti M. COVID 19 myocarditis: Myth or reality? J Saudi Heart Assoc 2020; 32:421-424. [PMID: 33299786 PMCID: PMC7721458 DOI: 10.37616/2212-5043.1135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/28/2020] [Accepted: 08/31/2020] [Indexed: 11/20/2022] Open
Abstract
COVID 19 so far is not a known cardiotropic virus, and the term “myocarditis” should be exclusively used after EMB or autopsy proven diagnosis. We report a case of 26-year-old man admitted for COVID 19 infection and symptoms leading to myocarditis. We describe the workup that led to the potential diagnosis.
Collapse
|
30
|
Snoussi NEH, Radi F, Oussou Y, Manouri K, El Hattab FZ, Cherti M. Left ventricular metastasis of osteosarcoma: A report of an unusual case. J Card Surg 2020; 35:3596-3599. [PMID: 32939815 DOI: 10.1111/jocs.15021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/19/2020] [Accepted: 09/03/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Secondary cardiac tumors are far more frequent than primary tumors. Cardiac metastasis of osteosarcoma is extremely rare. CASE PRESENTATION We report a 14-year-old child with left femur osteosarcoma that had metastasized to the left ventricle after 30 months of follow-up. The diagnosis was confirmed based on the findings of transthoracic echocardiography and fluorodeoxyglucose positron emission tomography/computed tomography. Surgical removal was indicated in the patient, but his parents refused this decision, and the patient was discharged and admitted to a pediatric oncology center for chemotherapy. The patient died after four courses of chemotherapy. CONCLUSION Cardiac metastasis of osteosarcoma is a strong predictor of disease. The demographic differences shown in our case include male sex and a short interval between onset and cardiac involvement.
Collapse
Affiliation(s)
- Nour El Houda Snoussi
- Department of Cardiology B, IBN SINA Hospital Center, Mohammed V University, Rabat, Morocco
| | - Fatimazohra Radi
- Department of Cardiology, Sud Francilien Hospital Center, Iles de France, France.,Division of Cardiology, Mohammed V University, Rabat, Morocco
| | - Yousra Oussou
- Department of Cardiology, Mohamed V Military Instruction Hospital, Mohammed V University, Rabat, Morocco
| | - Kawtar Manouri
- Department of Cardiology B, IBN SINA Hospital Center, Mohammed V University, Rabat, Morocco
| | - Fatima-Zahra El Hattab
- Department of Cardiology B, IBN SINA Hospital Center, Mohammed V University, Rabat, Morocco
| | - Mohamed Cherti
- Department of Cardiology B, IBN SINA Hospital Center, Mohammed V University, Rabat, Morocco
| |
Collapse
|
31
|
Diakite S, Radi FZ, Zarzur J, Cherti M. Myocardial infarction in a pregnant woman revealing a transitional deficit in protein S: a rare case report. Pan Afr Med J 2019; 34:27. [PMID: 31762895 PMCID: PMC6859020 DOI: 10.11604/pamj.2019.34.27.18614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 06/19/2019] [Indexed: 12/27/2022] Open
Abstract
The occurrence of myocardial ischemia and myocardial infarction in pregnancy is relatively rare, the occurrence of myocardial infarction in pregnancy is associated with cardiovascular risk factors. The deficiency of coagulation regulatory systems in the occurrence of venous thrombosis is well established; however, their role in arterial thrombosis is controversial. Here, we present an interesting case of a 34-year-old of acute myocardial syndrome without persistent ST segment elevation, which revealed transient protein S deficiency. Management of acute coronary syndrome (ACS) during pregnancy may represent a unique clinical challenge. In this manuscript, we review the clinical presentation, anatomic considerations, and management strategy in our patient presenting with ACS. Objective: this case highlights the importance of multimodality approach to help to obtain a more timely diagnosis of myocardial infarction in pregnancy and the importance collaboration between obstetricians, cardiologists, pediatricians and anesthesiologists to ensure optimal care.
Collapse
Affiliation(s)
- Souleymane Diakite
- Departement of Cardiology B, CHU Ibn Sina, Mohamed V University Rabat, Rabat, Morocco
| | - Fatima Zohra Radi
- Departement of Cardiology B, CHU Ibn Sina, Mohamed V University Rabat, Rabat, Morocco
| | - Jamila Zarzur
- Departement of Cardiology B, CHU Ibn Sina, Mohamed V University Rabat, Rabat, Morocco
| | - Mohamed Cherti
- Departement of Cardiology B, CHU Ibn Sina, Mohamed V University Rabat, Rabat, Morocco
| |
Collapse
|
32
|
Hattab FZE, Radi FZ, Hara L, Hafidi EM, Zarzur J, Cherti M. [Inferior myocardial infarction: first Moroccan study of 103 cases]. Pan Afr Med J 2019; 33:74. [PMID: 31448036 PMCID: PMC6689828 DOI: 10.11604/pamj.2019.33.74.16047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Accepted: 04/02/2019] [Indexed: 12/04/2022] Open
Abstract
L'infarctus du myocarde (IDM) représente une cause majeure de mortalité cardiovasculaire. L'IDM inférieur représente 30 à 50% de l'ensemble des infarctus avec un pronostic favorable par rapport à l'infarctus antérieur. Le but de notre travail est d'étudier les aspects épidémiologiques, cliniques, électriques, échocardiographiques et angiographiques de l'IDM inférieur, ainsi que ses complications et ses modalités thérapeutiques. Sur une période de 3 ans, nous avons admis 720 patients pour ST-Elevation Myocardial Infarction (STEMI) dont 103 de topographie inférieure soit une fréquence de 14,3%. On note une nette prédominance masculine avec une moyenne d'âge de 58 ans pour les hommes et 62 ans pour les femmes. Le tabagisme représente le principal facteur de risque cardiovasculaire retrouvé dans 57,28% des cas. L'infarctus ventricule droit (VD) est objectivé chez 11,65% des malades. La moitié de ces patients ont présenté une instabilité hémodynamique. Le Bicuspid aortic valve (BAV) 3ème degré a été diagnostiqué chez 12,6% des patients. Sur le plan thérapeutique, sept malades ont été thrombolysés et 42 ont bénéficié d'une coronarographie. La lésion coupable de l'IDM inférieur était la coronaire droite dans 53% des cas et l'artère circonflexe dans 47%. La coronaire droite est responsable de l'infarctus VD dans 100% des cas. L'angioplastie coronaire est réalisée chez 18 patients dans la suite de la coronarographie. Onze malades ont bénéficié d'une angioplastie transluminale (ATL) de la coronaire droite et celle de la circonflexe est réalisée chez 2 malades. La mortalité précoce à 30 jours est estimée à 1,94%. Dans le groupe de patients présentant un infarctus VD, la mortalité est aux alentours de 17%.
Collapse
Affiliation(s)
| | - Fatima Zohra Radi
- Service de Cardiologie B, Université Mohamed V Souissi, Rabat, Maroc
| | - Loubna Hara
- Service de Cardiologie B, Université Mohamed V Souissi, Rabat, Maroc
| | - El Mehdi Hafidi
- Service de Cardiologie B, Université Mohamed V Souissi, Rabat, Maroc
| | - Jamila Zarzur
- Service de Cardiologie B, Université Mohamed V Souissi, Rabat, Maroc
| | - Mohamed Cherti
- Service de Cardiologie B, Université Mohamed V Souissi, Rabat, Maroc
| |
Collapse
|
33
|
Hara L, El Hattab FZ, Radi FZ, Zarzur J, Cherti M. [Perforated posterior mitral valve aneurysm: a rare complication of infective endocarditis: a case report]. Pan Afr Med J 2019; 32:178. [PMID: 31312292 PMCID: PMC6620063 DOI: 10.11604/pamj.2019.32.178.17710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 01/15/2019] [Indexed: 11/11/2022] Open
Abstract
Mitral valve aneurysm is a rare abnormality whose pathophysiology is poorly understood. It is defined as a bulge of the mitral valve leaflet toward the left atrium. Aneurysm in the posterior leaflet is exceptional. We report the case of a 26-year old man, who had been followed up for rheumatic aortic regurgitation for 4-years, hospitalized for febrile syndrome associated with episodes of left heart failure. Transthoracic echocardiographic examination (TTE) and transesophageal echocardiography (TEE) showed aortic valve vegetations with wide aneurysm of the small mitral valve associated with severe mitral valve regurgitation. The patient underwent mitral and aortic valve replacement with simple postoperative outcome. Clinical suspicion associated with suitable preoperative imaging and early surgical treatment are essential to recognize and treat this rare complication of infectious endocard.
Collapse
Affiliation(s)
- Loubna Hara
- Service de Cardiologie B, CHU Ibn Sina, Rabat, Maroc
| | | | | | - Jamila Zarzur
- Service de Cardiologie B, CHU Ibn Sina, Rabat, Maroc
| | | |
Collapse
|
34
|
El Hattab FZ, Radi F, Hara L, Hafidi EM, Zarzur J, Cherti M. Asymptomatic Bilateral Internal Carotid Artery Occlusion Associated with Stenosis of the Right External Carotid Artery: Case Report. J Cardiovasc Dis Res 2019. [DOI: 10.5530/jcdr.2019.2.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
35
|
Harrak S, Doghmi N, Fellat B, Zarzur J, Cherti M. [Infective endocarditis in Morocco through the experience of a hospital department]. Ann Cardiol Angeiol (Paris) 2019; 68:87-93. [PMID: 30683481 DOI: 10.1016/j.ancard.2018.10.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 10/18/2018] [Indexed: 01/06/2023]
Abstract
Infective endocarditis is a grave disease because of a high level of morbidity and mortality. We conducted a retrospective analysis of 100 patients hospitalized for infective endocarditis from January 2009 until December 2015. The mean age was 41 years with a male predominance. Infective endocarditis occurs on a native valve (77 patients), prosthetic valves (12 patients), Pacemaker (7 patients) and congenital heart disease (4 patients). The diagnostic delay was 77 days on average. The fever was present in 85 patients. Blood cultures were negative in 54 patients. Echocardiography allowed visualizing the vegetations in 95 patients. In patients with prosthetics valves, a paraprosthetic regurgitation was diagnosed in 54 % of these patients and vegetation in 18 %. The main complications are heart failure (42), neurological (19), spleen (10) and renal (23) complications. The evolution under medical treatment was marked by the clinical-laboratory improvement in 57 patients, the lack of improvement with persistent fever in 21 patients. The mortality rate of our series is 23 %. Only seven patients underwent urgent surgery for hemodynamic and infectious indications. At the end of this work, it is emphasized that the epidemiological profile of infective endocarditis does not follow the changes of Wold. Its management is difficult in our context (significant diagnostic delay, often negative blood cultures, high level of morbidity, lack of recourse to early surgery). The improvement of this disease consistes of the prevention of acute articular rhumatism and the establishment of an heart team endocarditis to adapt international recommendations to our context.
Collapse
Affiliation(s)
- S Harrak
- Service de cardiologie B, centre hosipitalier universitaire Ibn Sina, Rabat, Maroc.
| | - N Doghmi
- Service de cardiologie B, centre hosipitalier universitaire Ibn Sina, Rabat, Maroc
| | - B Fellat
- Service de cardiologie B, centre hosipitalier universitaire Ibn Sina, Rabat, Maroc
| | - J Zarzur
- Service de cardiologie B, centre hosipitalier universitaire Ibn Sina, Rabat, Maroc
| | - M Cherti
- Service de cardiologie B, centre hosipitalier universitaire Ibn Sina, Rabat, Maroc
| |
Collapse
|
36
|
Fennich H, Doghmi N, Rim F, Belhaj S, Cheikhi F, Cherti M. Spontaneous rupture of right aortic sinus of Valsalva leading to massive cystic dissection of interventricular septum and complete heart block. Echocardiography 2018; 35:2109-2112. [PMID: 30338557 DOI: 10.1111/echo.14166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 09/20/2018] [Indexed: 11/30/2022] Open
Abstract
The interventricular septal dissection is an uncommon, and is occasionally associated with sinus of Valsalva aneurysm. A spontaneous dissection with a normal sinus of Valsalva is extremely rare and is mostly a result of a congenital defect. We report the case of a 23-year-old male admitted for complete heart block and presenting as an incidental finding during the TTE multiple and huge cystic-like mass in the interventricular septum (IVS) which is the TTE characteristic of IVS dissection. Most patients remain asymptomatic until the anatomical and hemodynamic changes lead to complications like: severe aortic regurgitation with heart failure and conduction abnormalities. Although transthoracic echocardiogram (TTE) has been the first-line imaging modality for such findings, cardiac computed tomography (CT) and magnetic resonance imaging have been increasingly used as supplemental or confirmatory tests. The imaging modalities showed a perforation of right sinus of Valsalva causing the expansion of the dissection to the apex. The patient underwent surgical repair with satisfying results. In conclusion, we report an extremely rare clinical case of spontaneous dissection of the interventricular septum using multiple imaging techniques and with a successful surgery.
Collapse
Affiliation(s)
- Hala Fennich
- Cardiology B Department of CHU Ibn Sina, Rabat, Morocco
| | - Nawal Doghmi
- Cardiology B Department of CHU Ibn Sina, Rabat, Morocco
| | - Fagouri Rim
- Cardiology B Department of CHU Ibn Sina, Rabat, Morocco
| | - Saad Belhaj
- Cardiothoracic surgery department of Clinique Agdal, Rabat, Morocco
| | | | | |
Collapse
|
37
|
Radi F, Zarzur J, Cherti M. Lyme disease revealed by complete heart block: Rare case report. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2018.02.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
38
|
El Aissaoui A, El Hangouche J, Fellat I, Doghmi N, Cherti M. Left Ventricular Apical Aneurysms : ‘unlucky’ find of CMR in Hypertrophic Cardiomyopathy. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30926-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
39
|
Abstract
Polyvalvular disease is not a rare condition, the lack of specific data for each situation does not allow perfoming standardized management and guidelines. We want to present by this review available data on the management of polyvalvular disease, taking into account different possible associations between the valve lesions.
Collapse
Affiliation(s)
- Z Raissuni
- Faculté de médecine de Tanger, université Abdelmalek Essaidi, Tanger, Maroc.
| | - A Abourazzak
- Faculté de médecine et de pharmacie de Rabat, université mohammed V Souissi, Rabat, Maroc
| | - L Hara
- Faculté de médecine et de pharmacie de Rabat, université mohammed V Souissi, Rabat, Maroc
| | - J Zarzur
- Faculté de médecine et de pharmacie de Rabat, université mohammed V Souissi, Rabat, Maroc
| | - M Cherti
- Faculté de médecine et de pharmacie de Rabat, université mohammed V Souissi, Rabat, Maroc
| |
Collapse
|
40
|
Kandoussi TE, Malki HE, Masmoudi AE, Loubaris M, Laaroussi M, Cherti M. Infective endocarditis presenting as acute coronary syndrome. Pan Afr Med J 2016. [DOI: 10.11604/pamj.2016.23.230.7429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
|
41
|
Charif D'Ouazzane M, Gueroui I, Betaich K, Bennani R, Touati Z, Haddour L, Cherti M. [A cardiac rhabdomyome evoking the antenatal diagnosis of a Bourneville's tuberous sclerosis]. Ann Cardiol Angeiol (Paris) 2015; 64:51-53. [PMID: 22621850 DOI: 10.1016/j.ancard.2012.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Accepted: 04/15/2012] [Indexed: 06/01/2023]
Abstract
Rare hereditary affection, the Bourneville's tuberous sclerosis (BTS) is an autosomal dominant inherited phakomatosis. Rhabdomyomes are the most frequent cardiac tumors in children and infants, they are one of the most premature modes of revelation of the STB. They sometimes allow to envisage the diagnosis in antenatal period at the same time as the genetic and neurological explorations. We report the diagnosis of a fetal BTS evoked by the antenatal discovery of a cardiac rhabdomyome. The antenatal cerebral explorations, realized by magnetic resonance imagery (MRI), put evidence cerebral localisations confirming the diagnosis.
Collapse
Affiliation(s)
| | - I Gueroui
- Service de cardiologie B, CHU Ibn Sina, Rabat, Maroc
| | - K Betaich
- Service de cardiologie B, CHU Ibn Sina, Rabat, Maroc
| | - R Bennani
- Service de cardiologie B, CHU Ibn Sina, Rabat, Maroc
| | - Z Touati
- Service de cardiologie B, CHU Ibn Sina, Rabat, Maroc
| | - L Haddour
- Service de cardiologie B, CHU Ibn Sina, Rabat, Maroc
| | - M Cherti
- Service de cardiologie B, CHU Ibn Sina, Rabat, Maroc
| |
Collapse
|
42
|
Saghi G, Bouhouch R, Salaheddine L, Birouk N, Nadifi S, Fellat I, Cherti M. Atteinte cardiaque au cours de la dystrophie myotonique de Steinert: expérience marocaine, à propos de 18 cas. Pan Afr Med J 2015; 20:131. [PMID: 26097635 PMCID: PMC4462558 DOI: 10.11604/pamj.2015.20.131.2751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2013] [Accepted: 02/17/2014] [Indexed: 11/26/2022] Open
Abstract
La maladie de Steinert ou dystrophie myotonique de type 1 (DM1) est une maladie génétique à transmission autosomique dominante caractérisée par une myotonie et une atteinte de plusieurs organes dont le cœur. L'atteinte cardiaque est la plus grave des atteintes systémiques puisqu'elle conditionne le pronostic vital. Ce travail a pour but de déterminer les anomalies cardiaques rencontrées au cours de la DM1 et de mettre en exergue l'intérêt d'un examen cardiaque rigoureux et régulier, indépendamment de la sévérité de l'atteinte neuromusculaire, ainsi que l'apport des examens cardiaques complémentaires et notamment l'exploration électrophysiologique. 18 patients atteints de DM1 ont bénéficiés d'une exploration cardiaque systématique. Il s'agit de 9 hommes et de 9 femmes, d’âge moyen de 41,8 +/- 16,2 ans. 66 p.100 des patients sont symptomatiques sur le plan cardiovasculaire. Les anomalies électrocardiographiques sont dominées par un trouble de la conduction intra-ventriculaire dans 16 p.100 des cas et un BAV de 1er degré dans 16 p.100 des cas. L'Holter ECG objective une hyperexcitabilité à l’étage atrial et/ou ventriculaire dans 50p.100 des cas. L'ETT est normale chez 95 p.100 des patients. L'exploration électrophysiologique, réalisée chez 4 patients symptomatiques, a objectivé un bloc tronculaire dans un cas ayant conduit à l'implantation d'un PM double chambre. Un seul patient est décédé suite à une détresse respiratoire. Enfin, on n'a pas noté de corrélation entre l'atteinte cardiaque et neuromusculaire. Une exploration cardiaque est indispensable chez tout patient atteint de DM1, en dépit de l'absence de symptômes, et un bilan annuel minimal s'impose pour guetter un éventuel trouble rythmique et/ou conductif, fatal en l'absence de traitement adéquat.
Collapse
Affiliation(s)
- Ghita Saghi
- Service de Cardiologie B, Maternité Souissi, CHU Ibn Sina, Rabat, Maroc
| | - Rachida Bouhouch
- Service de Cardiologie B, Maternité Souissi, CHU Ibn Sina, Rabat, Maroc
| | | | - Nezha Birouk
- Service de Neurophysiologie, Hôpital des Spécialités, CHU Ibn Sina, Rabat, Maroc
| | - Salama Nadifi
- Service de Neurogénétique, CHU Ibn Rochd, Casablanca, Maroc
| | - Ibtissam Fellat
- Service de Cardiologie B, Maternité Souissi, CHU Ibn Sina, Rabat, Maroc
| | - Mohamed Cherti
- Service de Cardiologie B, Maternité Souissi, CHU Ibn Sina, Rabat, Maroc
| |
Collapse
|
43
|
Mouram S, Fellat I, Cherti M. [Atrioventricular block after cardiac surgery: report of 23 cases]. Pan Afr Med J 2014; 19:297. [PMID: 25883725 PMCID: PMC4393960 DOI: 10.11604/pamj.2014.19.297.4614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Accepted: 07/06/2014] [Indexed: 12/02/2022] Open
Abstract
Le bloc auriculo-ventriculaire (BAV) représente une complication non négligeable de la chirurgie cardiaque. Il est responsable de séquelles lourdes et graves compromettant le pronostic de la maladie et conduisant à la mise en place d'un stimulateur cardiaque définitif. Il est primordial d’étudier et de déterminer les différents facteurs prédictifs de BAV post opératoire, son histoire naturelle, son incidence ainsi que le délai exact de la mise en place d'un pacemaker. Notre étude est une étude rétrospective descriptive à propos de 23 patients opérés pour chirurgie cardiaque sous circulation extracorporelle entre octobre 1989 et août 2010 ayant présentés des troubles conductifs auriculo-ventriculaires en post opératoire. Plusieurs facteurs de risque ont été étudiés dans notre série, liés surtout à l'atteinte directe du noeud auriculo-ventriculaire ou à l'ischémie myocardique. Le délai d'apparition du trouble conductif ainsi que le délai d'implantation on été également étudié. Plusieurs facteurs favorisants de survenue de BAV ont été identifiés liés essentiellement au type de la cardiopathie opérée avec une prédominance de la cardiopathie congénitale, d'autres facteurs ont été rapportés notamment la présence d'hypertrophie ventriculaire gauche (HVG) de troubles conductifs en préopératoire, une durée du clampage aortique et de CEC prolongée. La moitié des patients ont présenté un BAV immédiat. Le délai d'implantation par rapport à la date de la découverte du BAV varie dans notre série d'une implantation immédiate après le diagnostic positif (J0) à un délai d'implantation allant jusqu’à 57 jours. Plusieurs facteurs de risques déterminent la survenue de BAV post chirurgie cardiaque, leur connaissance est primordial ainsi que le délai exact de l'implantation du stimulateur cardiaque définitif.
Collapse
Affiliation(s)
- Sahar Mouram
- Service de Cardiologie B, Hopital d'Enfants, Faculté de Médecine et de Pharmacie de Rabat, Université Mohammed V- Souissi, Rabat, Maroc
| | - Ibtissam Fellat
- Service de Cardiologie B, Hopital d'Enfants, Faculté de Médecine et de Pharmacie de Rabat, Université Mohammed V- Souissi, Rabat, Maroc
| | - Mohamed Cherti
- Service de Cardiologie B, Hopital d'Enfants, Faculté de Médecine et de Pharmacie de Rabat, Université Mohammed V- Souissi, Rabat, Maroc
| |
Collapse
|
44
|
Mouine N, Amri R, Cherti M. Unusual findings in secondary hypertension: double orifice mitral associated to aortic coarctation, bicuspid aortic valve, and ventricular septal defect. Int Arch Med 2014; 7:14. [PMID: 24693935 PMCID: PMC3976167 DOI: 10.1186/1755-7682-7-14] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Accepted: 03/22/2014] [Indexed: 11/10/2022] Open
Abstract
Double orifice mitral valve is a rare congenital anomaly presenting as the division of the mitral orifice into two anatomically distinct orifices, it is most often associated with other congenital heart defects such as left-sided obstructive lesions, ventricular septal defects or aortic coarctation. We report the case of a 15 year’s old boy, admitted for arterial hypertension, auscultation revealed a rude aortic systolic murmur. Femoral pulses were weak. Owing to the suspicion of aortic coarctation, transthoracic echocardiography was performed, the aortic coarctation with dilation of the aorta proximal to the stenosis was confirmed and bicuspid aortic valve was found with good function. The mitral valve was dysmorphic, having two orifices; it was divided into 2 separate valve orifices by a fibrous bridge. No mitral or aortic regurgitation was documented by color Doppler flow imaging. The left ventricular ejection fraction was normal. There was a small peri membranous ventricular septal defect with left to right shunt. Owing to the severity of the aortic coarctation and taking into account the anatomy and characteristics of the patient, he was made a surgical correction of aortic coarctation with good outcome.
Collapse
Affiliation(s)
- Najat Mouine
- Department of Cardiology B, IBN SINA Hospital, Mohamed V University Souissi, Rabat, Morocco.
| | | | | |
Collapse
|
45
|
Raissuni Z, Doghmi N, Mousseaux E, Cherti M, Redheuil A. Hypertrophic cardiomyopathy mimicking STEMI: The role of cardiac magnetic resonance imaging in the detection of microvascular coronary dysfunction. Diagn Interv Imaging 2014; 95:1111-2. [PMID: 24560523 DOI: 10.1016/j.diii.2013.12.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Z Raissuni
- Service de Radiologie, Unité d'imagerie cardiovasculaire, Hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France.
| | - N Doghmi
- Service de Radiologie, Unité d'imagerie cardiovasculaire, Hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - E Mousseaux
- Service de Radiologie, Unité d'imagerie cardiovasculaire, Hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - M Cherti
- Service de Radiologie, Unité d'imagerie cardiovasculaire, Hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - A Redheuil
- Service de Radiologie, Unité d'imagerie cardiovasculaire, Hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| |
Collapse
|
46
|
Bennis K, Tamdy A, Charif D'ouazzane M, Assaidi A, Doghmi N, Allouch M, Noureddine M, Cherti M, Bennis A. [Isolated left ventricular congenital diverticulum in adult: Report of cardiac imaging]. Ann Cardiol Angeiol (Paris) 2014; 63:58-61. [PMID: 22436633 DOI: 10.1016/j.ancard.2011.07.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2010] [Accepted: 07/24/2011] [Indexed: 05/31/2023]
Abstract
Cardiac diverticulum is an infrequent congenital malformation, it's even more rare in adulthood. It's often associated with other thoraco-abdominal diverticulums, and rarely isolated. The diagnosis relies on echocardiography. By the way, the magnetic resonance imagery (MRI) allows a finer analysis of the diverticulum, its topography and its situation contributed to vascular and cardiac structures, it has largely replaced the ventriculography. We report in this article the case of a patient of 36 years whose diagnosis of the diverticulum was made by transthoracic echocardiography (TTE) at the time of an assessment of dyspnea, this exam also objectified a mitral insufficiency by deformation and dilatation of the mitral annulus. Radiological assessment was completed by a transoesophageal echocardiography (TOE) and magnetic resonance imagery (MRI). Surgical treatment consisted of surgical closing of the diverticulum and mitral annuloplasty.
Collapse
Affiliation(s)
- K Bennis
- Service de cardiologie, CHU IBN Rochd, Casablanca, Maroc
| | - A Tamdy
- Service de cardiologie B, maternité Suissi, CHU IBN Sinaa, Rabat, Maroc.
| | | | - A Assaidi
- Service de cardiologie, CHU IBN Rochd, Casablanca, Maroc
| | - N Doghmi
- Service de cardiologie B, maternité Suissi, CHU IBN Sinaa, Rabat, Maroc
| | - M Allouch
- Service de cardiologie, CHU IBN Rochd, Casablanca, Maroc
| | - M Noureddine
- Service de cardiologie, CHU IBN Rochd, Casablanca, Maroc
| | - M Cherti
- Service de cardiologie B, maternité Suissi, CHU IBN Sinaa, Rabat, Maroc
| | - A Bennis
- Service de cardiologie, CHU IBN Rochd, Casablanca, Maroc
| |
Collapse
|
47
|
Raissuni Z, Lachhab A, Haddour L, Doghmi N, Cherti M. [The role of multimodality imaging in the diagnosis of constrictive pericarditis]. Ann Cardiol Angeiol (Paris) 2014; 63:32-39. [PMID: 24210809 DOI: 10.1016/j.ancard.2013.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 10/02/2013] [Indexed: 06/02/2023]
Abstract
Constrictive pericarditis is a rare heart disease. The diagnosis remains a challenge. In fact, this illness can mimic restrictive cardiomyopathy. Echo-Doppler evaluation helps to establish the diagnosis of constriction; however, this technique is limited in its ability to image the entire pericardium because of its limited acoustic windows by air or bone of thorax. In addition, it is an operator-dependent exploration. Scanner and magnetic resonance imaging provide a large field of view and excellent images, showing the increased pericardial thickness and septal motion abnormalities. This review will consider the emerging role of these imaging modalities in the constrictive pericarditis diagnosis.
Collapse
Affiliation(s)
- Z Raissuni
- Service de cardiologie B, hôpitaux universitaires de Rabat, Rabat, Maroc.
| | - A Lachhab
- Service de cardiologie B, hôpitaux universitaires de Rabat, Rabat, Maroc
| | - L Haddour
- Service de cardiologie B, hôpitaux universitaires de Rabat, Rabat, Maroc
| | - N Doghmi
- Service de cardiologie B, hôpitaux universitaires de Rabat, Rabat, Maroc
| | - M Cherti
- Service de cardiologie B, hôpitaux universitaires de Rabat, Rabat, Maroc
| |
Collapse
|
48
|
Lachhab A, Doghmi N, Elfakir Y, Taoussi O, Benyass A, Haddour L, Zarzur J, Cherradi R, Fellat I, Aouad A, Ellouali F, Asfalou I, Elmajhad A, Cherti M. Insights from magnetic resonance imaging of left ventricular non-compaction in adults of North African descent. Int Arch Med 2012; 5:10. [PMID: 22405292 PMCID: PMC3327641 DOI: 10.1186/1755-7682-5-10] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2011] [Accepted: 03/09/2012] [Indexed: 01/22/2023] Open
Abstract
Background Left ventricular non-compaction (LVNC) is a recently recognized rare disorder. Magnetic resonance imaging (MRI) may help to clarify the uncertainties related to this genetic cardiomyopathy. Despite the fact that many articles have been published concerning the use of MRI in the study of LVNC, there is a lack of data describing the disease in the North African population. The aim of our study is to clarify MRI findings of LVNC in North African patients. Methods In our retrospective cohort, twelve patients (7 male, mean age 53 ± 8 years) underwent MRI for suspected LVNC. Correlations were investigated between the number of non-compacted segments per patient and left ventricular ejection fraction (LVEF), then between the number of non-compacted segments and left ventricular end diastolic diameter. The presence or absence of late gadolinium enhancement (LGE) was qualitatively determined for each left ventricular myocardial segment. Results Non-compaction was more commonly observed at the apex, the anterior and the lateral walls, especially on their apical and mid-cavity segments. 83% of patients had impaired LVEF. There was no correlation between the number of non-compacted segments per patient and LVEF (r = -0.361; p = 0.263), nor between the number of non-compacted segments per patient and left ventricular end diastolic diameter (r = 0.280; p = 0.377). LGE was observed in 22 left ventricular segments. No association was found between the pattern of fibrosis and non-compaction distribution (OR = 2.2, CI [0.91-5.55], p = 0.076). Conclusion The distribution of LVNC in North African patients does not differ from other populations. Ventricular dysfunction is independent from the number of non-compacted segments. Myocardial fibrosis is not limited to non-compacted areas but can extend to compacted segments.
Collapse
Affiliation(s)
- Amal Lachhab
- Cardiology B Department, Ibn Sina University Hospital, Rabat, Morocco
| | - Nawal Doghmi
- Cardiology B Department, Ibn Sina University Hospital, Rabat, Morocco
| | | | - Omar Taoussi
- Radiology Nakhil Department, Agdal Clinic, Rabat, Morocco
| | - Aatef Benyass
- Military Cardiology Department, Ibn Sina University Hospital, Rabat, Morocco
| | - Laila Haddour
- Cardiology B Department, Ibn Sina University Hospital, Rabat, Morocco
| | - Jamila Zarzur
- Cardiology B Department, Ibn Sina University Hospital, Rabat, Morocco
| | - Rhizlane Cherradi
- Cardiology B Department, Ibn Sina University Hospital, Rabat, Morocco
| | - Ibtissam Fellat
- Cardiology B Department, Ibn Sina University Hospital, Rabat, Morocco
| | - Aicha Aouad
- Cardiology B Department, Ibn Sina University Hospital, Rabat, Morocco
| | - Fedoua Ellouali
- Cardiology B Department, Ibn Sina University Hospital, Rabat, Morocco
| | - Ilyas Asfalou
- Military Cardiology Department, Ibn Sina University Hospital, Rabat, Morocco
| | - Amin Elmajhad
- Cardiology B Department, Ibn Sina University Hospital, Rabat, Morocco
| | - Mohamed Cherti
- Cardiology B Department, Ibn Sina University Hospital, Rabat, Morocco
| |
Collapse
|
49
|
Lachhab A, Doghmi N, Ouenzar M, Bennani R, Amri R, Cherti M. Manifestations cardiovasculaires de la maladie de Marfan. Presse Med 2012; 41:328-30. [DOI: 10.1016/j.lpm.2011.05.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2011] [Revised: 04/05/2011] [Accepted: 05/04/2011] [Indexed: 10/17/2022] Open
|
50
|
Lachhab A, Doghmi N, Elfakir Y, Taoussi O, Benyass A, Haddour L, Zarzur J, Cherradi R, Fellat I, Aouad A, Ellouali F, Asfalou I, Elmajhad A, Cherti M. 113 Myocardial fibrosis and left ventricular non compaction in north african patients. Archives of Cardiovascular Diseases Supplements 2012. [DOI: 10.1016/s1878-6480(12)70509-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|