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Double Emergency Pulmonary Embolism and Aortic Dissection: About a Clinical Case

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World Journal of Cardiovascular Diseases 2020年第8期10卷 550-557页

作者： Coumba Thiam Boubacar Sonfo Youssouf Camara Souleymane Sanogo Hamidou Oumar Bâ Sidibé Samba Massama Konaté asmaou keita Sako Mariam Mahamadou Cissé Ibrahima Sangaré Massama Camara Menta Ichaka Cardiology Department of CHU Kati Bamako Mali Imaging Department CHU Mère-Enfant Bamako Mali Cardiology Department CHU Gabriel Touré Bamako Mali Cardiology Department CHU Point G Bamako Mali Internal Medicine Service Mali Hospital Bamako Mali Cardiology Department CHU Mère-Enfant Bamako Mali

Introduction: Pulmonary embolism and aortic dissection are two formidable cardiovascular emergencies. Their exceptional association has a poor prognosis with very high mortality. The aim of our study was to report the case of a 31-year-old patient with pulmonary embolism associated with De Bakey’s type I aortic dissection, admitted to the cardiology department of Kati University Hospital. Case Presentation: We report the case of a young patient of 31 with no known cardiovascular history, on estrogen-progestogen contraception for 10 years, who consults for a left basal thoracic pain of increasing intensity, a whitish productive cough, hemoptysis and dyspnea stage III. She was admitted to the cardiology department, transthoracic cardiac ultrasound objectified aortic insufficiency, dissection of the aorta, the presence of the intimal flap, the false and the true channel, dilation of the right cavities with HTAP. The chest CT scan revealed bilateral lobar and segmental pulmonary embolism, De Bakey’s type I aortic dissection. Medical treatment was instituted for hemodynamic stabilization at the end of sending her to a center specializing in cardiovascular surgery for better management; unfortunately she succumbed before the preparations for her evacuation were finished. Conclusion: The pulmonary embolism associated with aortic dissection constitutes a medical emergence of rare incidence in a cardiological environment;if the diagnosis was quickly made in our patient, the lack of technical platform m

关键词： Pulmonary Embolism Aortic Dissection CHU Kati

Epidemiological, Clinical and Coronary Angiography Aspects of Acute Coronary Syndrome in the Cardiology Department of the Hospital Mother-Child “Le Luxembourg”Mali

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World Journal of Cardiovascular Diseases 2024年第4期14卷 228-233页

作者： Sidibé Samba Toure Mamadou Konate Massama Sankaré Hamma Traoré Ousmane Mahamat Guire Sadik Diall Mahan Ameri Dicko Bahaide Daffe Sanoussy keita asmaou Thiam Coumba Adiaratou Diarra Soumaila Menta Ichaka Cardiology Department CHU-M&#232re Enfant Bamako Mali Cardiology Department CHU-Point G Bamako Mali Faculty of Medicine University of Sciences Techniques and Technologies of Bamako Bamako Mali Cardiology Department CHU-Gabriel Tour&#233 Bamako Mali Cardiology Department Mali Hospital Bamako Mali

Introduction: Cardiac catheterisation plays a fundamental role in the management of acute coronary syndrome. These explorations require heavy, complex and costly equipment and a large team of doctors, nurses and technicians with highly specialized training. Aims: To describe epidemiological, clinical and coronary angiography aspects of patients with acute coronary syndrome. Patients and Methods: Descriptive study from September 2019 to December 2023 in the Cardiology Department of the Hôpital Mère-Enfant of Bamako. Inclusion criteria were patients admitted for coronary angiography with the diagnosis of acute coronary syndrome. Results: During the study period, 1253 patients underwent coronary angiography, 596 of whom had acute coronary syndrome as an indication, representing a hospital frequency of 47%. Sex-ratio was 2.10. Mean age of patients was 58.5 ± 11.39 years. ST elevation acute coronary syndrome was the most common indication with 63.92% of cases. High blood pressure was the main cardiovascular risk factor with 58.7% of cases, and radial access approach was used in 98% of cases. Coronary angiography was pathological in 91.70% of cases (n = 548). Patients with lesions of anterior interventricular artery were 73.73% of cases. Tritruncal lesions accounted for 40.63% of cases. Conclusion: ST elevation acute coronary syndrome is the most frequent manifestation of acute coronary syndrome. Anterior interventricular artery is most often the culprit lesion for our patients.

关键词： Coronary Angiography Acute Coronary Syndrome Bamako Mali

Ischemic Stroke Revealing Infective Endocarditis in a Young Subject: About a Clinical Case

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World Journal of Cardiovascular Diseases 2022年第4期12卷 209-215页

作者： Coumba Thiam Boubacar Sonfo Massama Konaté Mahan Ameri Abba Diall asmaou keita Mariam Sako Youssouf Camara Hamidou Oumar Bâ Ibrahima Sangaré Mamadou Touré Samba Sidibé Massama Camara Simo Moyo Souleymane Coulibaly Ichaka Menta Cardiology Department of Kati University Hospital Kati Mali Internal Medicine Department of Mali Hospital Bamako Mali Cardiology Department of the Mother-Child University Hospital Bamako Mali Cardiology Department CHU Point G Bamako Mali Cardiology Department of the CHU Gabriel Touré Bamako Mali

Introduction: Neurological complications are possible during infective endocarditis. They are often life-threatening and can be a source of sequelae. Case Presentation: We report the case of an 11-year-old patient admitted to the cardiology department of the CHU-ME “LUXEMBOURG” in Bamako for functional impotence of the left hemibody, accompanied by fever and NYHA stage II dyspnea. The clinical examination on admission shows the poor general condition, normal consciousness, and sensory-motor deficit of the pyramidal type of the left hemibody. The cardiovascular examination notes a systolic murmur at the mitral focus, hepato-jugular reflux, hepatomegaly, and slight edema in the lower limbs. Brain CT showed localized hypodensity in favor of an ischemic stroke. The electrocardiogram shows a sinus rhythm. Transthoracic Doppler echocardiography revealed mitral insufficiency with vegetation of 17 × 14 mm on the anterior mitral valve, with left ventricular ejection fraction estimated at 75%. Dual antibiotic therapy associated with conventional treatment for heart failure was initiated. The clinical evolution was marked by the persistence of the deficit of the left upper limb, the cardiac Doppler echography of control after 6 weeks of treatment found the same vegetation. A discussion with the heart team with a view to a surgical cure has been initiated for the rest of the treatment. Conclusion: A motor deficit associated with fever related to an ischemic vascular accident should lead to a search for infective endocarditis on cardiac Doppler ultrasound.

关键词： Ischemic Stroke-Infectious Endocarditis-Young Subject

Metabolic Syndrome: Epidemiological, Clinical and Biological Profiles in the Cardiology and Internal Medicine Departments of the Mother-Child CHU “Luxembourg”

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World Journal of Cardiovascular Diseases 2021年第12期11卷 593-602页

作者： asmaou keita Boubacar Sonfo Sanoussi Daffé Daouda Fofana Coumba Thiam Oumar Doucouré Souleymane Diallo Mariam Sako Massama Konaté Hamidou Omar Bâ Youssouf Camara Ibrahima Sangaré Souleymane Coulibaly Ichaka Menta Mamadou Bocary Diarra Cardiology Department of CHU Mère-Enfant Bamako Mali Cardiology Department of CHU Kati Bamako Mali Cardiology Department of CHU Point G Bamako Mali Internal Medicine Department Mali Hospital Bamako Mali Cardiology Department of CHU Gabriel Touré Bamako Mali

Introduction: The metabolic syndrome is a clinical entity defined by the association in the same subject of four of the following five factors: abdominal obesity (or android), type 2 diabetes, hypertension, hypo HDL cholesterolemia, hypertriglyceridemia. The aim of the work was to study the epidemiological, clinical-biological profiles and complications of patients in the cardiology and internal medicine department of the Mother-Child CHU “Luxembourg”. Materials and Methods: We carried out a cross-sectional study, from September 2019 to June 2020 in the cardiology and internal department of the mother-child CHU “Luxembourg”. All patients with metabolic syndrome admitted to the two departments who agreed to participate during the study period were included in the study. These patients meet the 2009 harmonization attempt criteria (IDF 2009). The variables studied were: socio-demographic characteristics (sex, age, profession), pathological history, clinical signs (functional signs, BMI, waist size), paraclinical signs (ECG, cardiac ultrasound, laboratory assessment) and complications. Results: A total of 104 patients were included. The female sex represented 58.65% of cases. The 60 to 69 age group was the majority with 40.78%, housewives occupied 41.34% of cases. Diabetes, arterial hypertension and dyslipidemia were the most represented cardiovascular risk factors with respectively: 80.77%, 79.81% and 53.85%. Visual blurring was the most common functional sign with 23.08% of cases. Moderate obesity was observed in 34% of patients. Waist circumference was high in 39.53% of male patients and 37.70% of female patients. Cardiac ultrasound found a severely collapsed ejection fraction in 25% of patients. HDL-c levels were low in 64.52% of male patients and 75% of female patients. The most observed complications were: dyslipidemia (53.85%), stroke and renal failure with 23% respe

关键词： Metabolic Syndrome Epidemiological Profiles Clinical-Biological CHUME Luxembourg Bamako

Venous Thromboembolic Disease in the Cardiology Department of the Nianakoro Fomba Hospital in Segou (HNF)

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World Journal of Cardiovascular Diseases 2022年第11期12卷 507-513页

作者： Mariam Sako Mamadou Touré Boureima Dembélé Yves R. Koumaré Massama Konaté Mamadou Diakité Coumba Thiam Aniessa Kodio Samba Sidibé asmaou keita Aichata Dao Youssouf Camara Boubacar Sonfo Bassirima Traoré Souleymane Mariko Souleymane Coulibaly Ichaka Menta Point G Hospital Bamako Mali Mother Child Hospital Luxembourg Bamako Mali Mali Hospital Bamako Mali Kati Hospital Kati Mali Ségou Hospital Ségou Mali Tombouctou Hospital Tombouctou Mali Gabriel Touré Hospital Bamako Mali

Venous thromboembolic disease (VTE) is a nosological group that consists mainly of deep vein thrombosis (DVT) and pulmonary embolism (PE). The objective of our study was to determine the hospital prevalence of VTE in this Nianakoro Fomba Regional Hospital (HNF) in Ségou, Mali, to describe the sociodemographic aspects of these patients and the therapeutic possibilities in this locality. Materials and Methods: We conducted a prospective descriptive study from June 2019 to June 2020 in the cardiology department of the HNF of Ségou. All patients of all ages and both sexes who had VTE on clinical and paraclinical criteria (pulmonary Angio scan and/or venous Doppler echo) during the study period were included. Result: 31 patients were included out of 366 hospitalized patients, with a hospital prevalence of 8.47%. The 41-60 and 61 - 80 age groups were both dominant with 35.48% of cases each. The female sex was the most represented with 58.06% of cases and a sex ratio of 0.97. High blood pressure (hypertension) was the preeminent cardiovascular risk factor in 32.2% of cases and predisposing factors for VTE were dominated by immobilization (41.94%), peripartum (16.13%) and heart failure (16.13%). Dyspnea and chest pain were the frequent reasons for consultation with 93.54% and 83.87% of cases respectively and 6 patients (19.35%) had calf pain. More than 3/4 of the patients had tachypnea or 90.32% and tachycardia in nearly 74.19%. The clinical probability of VTE was intermediate at 51.61% according to the Wells score. D-Dimers were elevated in 38.70%, or all 12 patients who performed it. The electrocardiogram (ECG) recorded a sinus rhythm in 93.54% of cases, a right branch block and atrial fibrillation (AF) in 35.48% and 6.45% of cases, respectively. Dilation of the right ventricle was present in 64.51% of cases with PAH in 61.29% on cardiac Doppler ultrasound. In the majority of cases (82.15%) it was a massive bilateral proximal and distal pulmonary embolism. Treatment was b

关键词： Venous Thromboembolic Disease Nianakoro Fomba-Ségou-Mali Hospital

Evolutionary and Prognostic Aspects of Thrombolysed Patients for Acute Coronary Syndrome ST+ at CHU Ernesto Guevara De La Serna. Las Tunas (Cuba)

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World Journal of Cardiovascular Diseases 2020年第7期10卷 437-445页

作者： Boubacar Sonfo Hamidou Oumar Bâ Youssouf Camara Coumba Thiam Ibrahima Sangaré Massama Konaté Sidibé Samba Sako Mariam asmaou keita Coulibaly Souleymane Ilo Bella Diall Menta Ichaka Amadou Khalil Traoré Yudelquis Ojeda Riquenes Maikel Santos Medina Cardiology Department of CHU Kati Bamako Mali Cardiology Department CHU Gabriel Touré Bamako Mali Internal Medicine Service Mali Hospital Bamako Mali Cardiology Department CHU Point G Bamako Mali Cardiology Department CHU Mère-Enfant Bamako Mali Cardiology Department CHU Ernesto Guevara Las Tunas Cuba

Introduction: Acute myocardial infarction (IDM) occupies the first place in terms of mortality, among ischemic pathologies. Thrombolysis in the case of medical treatment for acute myocardial infarction (AMI) is undoubtedly the most revolutionary performed to date in this context, with a significant reduction in the mortality rate. The aim of our study was to describe the epidemiological aspects, the criteria for myocardial reperfusion post thrombolysis, the complications during thrombolysis and the complications of acute myocardial infarction in the cardiology department of the CHU Ernesto Guevara De La Serna of Las Tunas (Cuba). Methods: A retrospective cross-sectional descriptive study was carried out from June 2009 to December 2011. The patients hospitalized during this period in the USIC (coronary intensive care unit) for SCA ST(+) were included in the study. The variables studied were: Age, sex, myocardial reperfusion criteria, complications during thrombolysis and complications of myocardial infarction. Results: A total of 207 patients were included. The male sex represented 72.5% of the cases, giving a sex ratio of 2.63. The age group > 60 years was predominant with 54.2% of the cases. Thrombolysed patients represented 65.2% of the cases. Myocardial reperfusion criteria were observed in the majority of thrombolysed patients: relief of precordial pain (77%), regression of the ST segment to

关键词： Acute Coronary Syndrome Thrombolysis CHU Las Tunas Cuba

Therapeutic Compliance of Hypertensive Patients Followed in Ambulatory in the Cardiology Department of Kati University Hospital

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World Journal of Cardiovascular Diseases 2024年第5期14卷 333-342页

作者： Boubacar Sonfo Coumba Thiam Mariam Sako Massama Konaté Youssouf Camara Mamadou Touré Boubacar Diarra Diakaridja Sacko Samba Sidibé Bassan Diarra Hamidou Camara asmaou keita Konimba Diarra Hamidou Oumar Bâ Ibrahima Sangaré Youssouf Guindo Sanoussi Daffe Daouda Fofana Souleymane Coulibaly Ichaka Menta Department of Cardiology University Hospital Bocar Sidy Sall Kati Mali Department of Cardiology University Hospital of Point G Bamako Mali Department of Cardiology Mali Hospital Bamako Mali Department of Cardiology University Hospital Mother-Child Luxembourg Bamako Mali Department of Cardiology University Hospital Gabriel Tour&#233 Bamako Mali Department of Cardiology Kayes Hospital Kayes Mali

Introduction: High blood pressure is a major public health problem worldwide due to its frequency and cardiovascular complications. Adherence to treatment for chronic diseases is a global problem. The aim was to study therapeutic adherence in hypertensive patients followed in ambulatory. Materials and Methods: This was a cross-sectional, descriptive study with prospective recruitment that took place from July 1 to December 31, 2022 (6 months) in the cardiology department of the university hospital of Kati. The variables studied were sociodemographic data, cardiovascular risk factors, comorbidities, the possession of insurance and compliance (the Girerd questionnaire was used to assess adherence). Results: A total of 1182 patients were consulted, including 887 for hypertension, a frequency of 75%. Fifty-six patients were included in the study. The average age was 58.18 ± 13.25 years with extremes of 30 and 80 years. There was a female predominance (75%) with a sex ratio of 0.3. The majority of patients lived in urban areas (89.3%). Out-of-school patients accounted for 44.6%, more than half of patients or 55.4% had no income, patients with medical coverage accounted for 67.9% of cases. The main risk factors were physical inactivity (25%) followed by smoking 14.3%. More than 71% of patients had a compliance problem and the main reasons were forgetting to take the drug with 73.2%, followed by delayed treatment of 50% and drug discontinuation of 28.6%. Conclusion: Compliance is a real challenge and a major public health issue. This study allowed us to find a real problem of compliance in our hypertensive patients. There was a statistically significant relationship between drug adherence and forgetting to take the drug and drug discontinuation.

关键词： Hypertensive Therapeutic Adherence University Hospital of Kati

Percutaneous Coronary Intervention in Acute Coronary Syndromes at the Mother-Child University Hospital Luxembourg in Bamako

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World Journal of Cardiovascular Diseases 2024年第4期14卷 288-294页

作者： Mamadou Toure Hamma Sankare Baba I. Diarra Mariam Dagnogo Modibo Doumbia Abdoul W. Terra Samba Sidibe Coumba A. Thiam Boubacar Sonfo Boubacar Diarra asmaou keita Ousmane Traore Daouda Fofana Almou A. Diall Mady Sow Massama Konate Hamidou O. Ba Ichaka Menta Cardiology Department CHU-Mother Child Bamako Mali Cardiology Department CHU-Gabriel Tour&#233 Bamako Mali Faculty of Medicine University of Sciences Techniques and Technologies of Bamako Bamako Mali Department of Cardiac Surgery Center Andre FESTOC Bamako Mali Cardiology Department CHU-Point G Bamako Mali

Introduction: Acute coronary syndromes (ACS) are a diagnostic and therapeutic emergency. Objective: Studying the feasibility, difficulties and results of coronary angioplasty in acute coronary syndromes at the Luxembourg Mother-Child University Hospital in Bamako. Patients and Methods: Cross-sectional, descriptive study with prospective recruitment over 18 months from September 2020 to February 2022. All patients aged at least 18 years old admitted for SCA and having undergone PCI during the study period were included. Result: We collected 249 patients for SCA, of whom 160 underwent angioplasty, either an angioplasty/SCA ratio of 0.64. The average age of the patients was 59.54 ± 11.62 with extremes of 32 and 92 years. The age group of 45 to 65 years was the most representative. The predominance was male, sex ratio of 2.4. The main cardiovascular risk factors were high blood pressure (58.23%) and diabetes (45.78%). Persistent ST-segment elevation on the electrocardiogram was present in 71.48%. The treatment time was more than 12 hours after the first medical contact in 95.5%. The approach was radial in 96.5% of cases. Coronarography was pathological in 91.16% of our patients. The lesions were tri-truncular in 34.13% with the anterior inter ventricular as culprit artery in 72% of cases. The majority of patients (64%) had undergone angioplasty with implantation of an active stent. Angioplasty was performed successfully in 98% and per procedural mortality was 1.87%. Only 6.45% of ACS with ST elevation benefited from primary angioplasty. Conclusion: Percutaneous coronary intervention is performed routinely in our center with satisfactory results. Difficulties exist, related to the diagnostic delay of ACS and the high cost of angioplasty.

关键词： Acute Coronary Syndromes Coronary Angiography Angioplasty Mother-Child University Hospital Luxembourg Bamako Mali

Acute Coronary Syndrome of Young Subjects at the Luxembourg Mother-Child University Hospital in Bamako

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World Journal of Cardiovascular Diseases 2024年第3期14卷 157-165页

作者： Mamadou Toure Mariam Dagnogo Massama Konate Mariam Sako Daouda Fofana Hamma Sankare Almou A. Diall Modibo Doumbia Baba I. Diarr Mady Sow Abdoul Wahhab Terra Coumba A. Thiam Boubacar Sonfo Boubacar Diarra asmaou keita Ousmane Traore Hamidou O. Ba Ichaka Menta Cardiology Department CHU-Mother Child Bamako Mali Cardiology Department CHU-Gabriel Tour&#233 Bamako Mali Faculty of Medicine University of Sciences Technics and Technologies of Bamako Bamako Mali Center Andre FESTOC Department of Cardiac Surgery of Bamako Mali Bamako Mali

Introduction: Acute coronary syndrome is often the first event of coronary disease of young subjects. Objective: To study sociodemographic, clinical, paraclinical, therapeutic and evolutionary aspects of acute coronary syndrome of young subjects. Patients and Methods: Descriptive cross-sectional study with prospective recruitment from October 01, 2020 to March 31, 2022. Were included all patients admitted for acute coronary syndrome whose age was less or equal to 45 years and who had undergone coronary angiography at the Mother-Child University Hospital on Luxembourg from Bamako. Results: During the study period, we collected 60 patient files out of 198. These 60 patient files met our inclusion criteria. Hospital frequency was 30.30%. Average age of patients was 40.43 ± 3.9 years. Sex ratio M/F was 5.3. Main cardiovascular risk factor was smoking tobacco (23.42%), followed by dyslipidemia (13.92%). Functional signs were dominated by angina 62% followed by dyspnea 25.3%. Persistent ST-segment elevation on electrocardiogram was present in 76.4%. Left ventricular systolic dysfunction was present in 26.5%. Time to first medical contact was more than 12 hours in 62.7% of cases. Radial approach was adopted in 94% of cases. Coronary angiography was pathological in 85% (n = 51) of cases. Lesions were single-vessel disease in 47.1% and culprit artery was anterior interventricular in 51% of cases. Dual anti-platelet aggregation was aspirin and ticagrelor in 91.8% of cases. Angioplasty was performed in all patients who had significant abnormalities at coronary angiography. In-hospital mortality was 3.9%. Conclusion: Acute coronary syndromes exist in young Africans with a male predominance. Main cardiovascular risk factor is smoking tobacco. Coronary lesions are single vessel disease in the majority of case. Most of patients meet medical team after 12 hours. Time to first medical contact is a main challenge in our country.

关键词： Acute Coronary Syndrome Young Subjects Coronary Angiography CHU Luxembourg Bamako