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Prognostic Factors Associated with Aortic Dissection at the Cardiac Intensive Care Unit of the Point “G” Hospital University Center, Bamako, Mali

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World Journal of Cardiovascular Diseases 2019年第9期9卷 657-664页

作者： Sidibé Samba Konaté Massama Thiam Coumba Adiaratou Coulibaly Souleymane Somnoma Jean-Baptiste Tougouma Dagnoko mariam Sacko Abdoul Karim Sako Mariam Mariko Souleymane Diakite Mamadou Menta Ichaka Diallo Boubakar Cardiology Department Point “G” Hospital University Center Bamako Mali Cardiology Department Hospital Mali Bamako Mali Cardiology Department Hospital Kati Bamako Mali Higher Institute of Health Sciences Nazi Boni de Bobo Dioulasso University Bobo Dioulasso Burkina Faso Cardiology Department Hospital Tombouctou Tombouctou Mali Cardiology Department Gabriel TOURE Hospital University Center Bamako Mali

Objective: The purpose of this study was to describe the prognostic factors associated with aortic dissection with the cardiology intensive care unit of the Point “G” Hospital University Center. Methodology: This was a descriptive transversal study from January 2010 to February 2017 that included all inpatients during this period. Results: Of 6912 patients admitted, 23 patients were admitted for an aortic dissection, a frequency of 0.33%. Of these, (6) six were under age 50 (26.1%) and the majority age group was 50 - 69 years old. Cardiovascular risk factors were high blood pressure, smoking, and diabetes with 73.9%, 60% and 13% of cases, respectively. At the clinic, chest pain and dyspnea were the main symptoms with respectively 65.2% and 52.2% and with 56.5% asphygmy was associated with pain. Para-clinically, renal failure and anemia were the major laboratory abnormalities found with respectively 43.75% and 31.25% of cases. Doppler echocardiography revealed lesions associated with aortic dissection. In the thoracic angioscan, the aortic dissection was type A (43.5%) and 56.5% type B. The co-morbidities, the associated lesions and the hemodynamic state of the patient indicate the degree of urgency. The treatment was medical. The evolution was full of complications with 52.2% of deaths including 7 (seven) type A patients. Intra-hospital death was 26.1%. Other complications were heart failure (47.8%), the renal failure (43.75%) and an aortic aneurysm (34.8%). Conclusion: Aortic dissection is a life-threatening medical and surgical emergency.

关键词： Aortic Dissection Pronostics Bamako

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Epidemio-Clinical, Therapeutic and Evolutive Aspects of Aortic Dissection in the Cardiology Department in Poin “G” Hospital University Center Bamako

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World Journal of Cardiovascular Diseases 2018年第8期8卷 424-430页

作者： Samba Sidibé Coumba Adiaratou Thiam Abdoul Karim Sacko Mamadou Diakite mariam Dagnoko Souleymane Coulibaly Nouhoum Diallo Hamidou Omar Ba Ibrahima Sangaré Somnoma Jean-Baptiste Tougouma Massama Konaté Oumar Daouda Koné Mamadou Touré mariam sako Ichaka Menta Illo Bela Diall Boubakar Diallo Cardiology Department Point “G” Hospital University Center Bamako Mali Cardiology Department Hospital Kati Bamako Mali Cardiology Department Gabriel TOURE Hospital University Center Bamako Mali Higher Institute of Health Sciences Nazi Boni de Bobo Dioulasso University Bobo Dioulasso Burkina Faso Cardiology Department Hospital Mali Bamako Mali Medical Department of Institute for Studies and Research Bamako Mali

Objective: The work aimed at describing an epidemioclinical, therapeutic and evolutionary characteristics of patients hospitalized for aortic dissection in the cardiology department in Point “G” Hospital University Center in Bamako—Mali. Methodology: It was a descriptive cross-sectional study from January 2010 to February 2017 in the CHU Point G cardiology department, including all patients hospitalized during this period. Results: Of 6912 hospitalized patients, 23 patients were concerned by aortic dissection. The prevalence of aortic dissection was 0.33%. The most affected age group was 50 - 69 (43.5%) of patients. The predominance was male with a sex ratio of 4.75. The cardiovascular risk factors were high blood pressure (73.9%) and smoking (60.9%). The major functional signs were chest pain (65.2%) and dyspnea (65.2%). Asphygmy (56.5%) and breath of aortic insufficiency (60.9%) were the dominant physical signs. The electrocardiogram recorded sinus tachycardia with 86.9% of patients. The radiographic of the frontal thorax showed mediastina widening (73.9%). At echocardiography, dilatation of the ascending aorta was described with 73.9% and the intimal veil (47.8%). Pericardial effusion was observed with 26.1% of patients. In the thoracic angioscan, the aortic dissection gave 43.5% for type A and 56.5% for type B. The aneurysm of the aorta was abdominal with 21.7%, ascending portion (13.0%) and descending with 8.7%. Complications were dominated by heart failure (47.8%) and aneurysm of the aorta (34.8%). The lethality was 52.2%. Conclusion: Aortic dissection is a medical and surgical emergency with poor prediction.

关键词： Aortic Dissection Cardiology Point G Hospital

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Venous Thromboembolic Disease in a Regional Hospital in Mali

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World Journal of Cardiovascular Diseases 2023年第12期13卷 837-844页

作者： Coulibaly Souleymane Taoré Djénébou Sidibé Samba Sako Mariam Guindo Aissata Sanogo Alpha Kodio Aniéssa Dao Aissata B. A. Hamidou Oumar Diakité Mamadou Konaté Massama Menta Ichaka Cardiology Department CHU Point G Bamako Mali Department of Internal Medicine CHU Point G Bamako Mali Cardiology Department Nianankoro Fomba Hospital in Ségou Ségou Mali Cardiology Department CHU Gabriel Touré Bamako Mali Mali Hospital Medicine Service Bamako Mali

Introduction: Venous thromboembolism (VTE) is a nosological group which mainly includes deep vein thrombosis (DVT) and pulmonary embolism (PE), it is frequently associated with high morbidity and mortality. We initiated this study with the aim of studying VTE in a cardiological hospital environment in a regional hospital in Mali. Methodology: This was a descriptive study with prospective recruitment over 1 year from June 20, 2019 to June 20, 2020, covering patients hospitalized and followed in consultation in the cardiology department of the Ségou regional hospital in Mali. Results: We collected 31 cases of VTE out of 366 patients, representing a frequency of 8.47%. The sex ratio was 0.88. VTE risk factors were dominated by immobilization (29.03%), pregnancy and postpartum (16.12%), heart failure (16.12%). The reason for consultation was dyspnea (93.54%) followed by chest pain (83.87%). On admission the clinical manifestations were tachycardia (74.19%), tachypnea (90.32%), muffled heart sounds (70.96%), global heart failure syndrome (51.6%). According to VTE probability scores;51.61% of patients had an intermediate clinical probability according to the simplified Wells score for PE and 54.84% had an intermediate clinical probability for the simplified Geneva score for DVT. D-Dimers were only performed in 12 patients (38.70%) and were elevated in all. A chest CT angiogram showed PE in 90% of patients (n = 28/31). Venous Doppler ultrasound of the lower limbs showed venous thrombosis in 3 patients. Conclusion: Venous thromboembolism, although underdiagnosed, is common in our health structures. Prevention, particularly heparinoprophylaxis and early recovery in a hospital environment, remains the effective means of combating this condition.

关键词： Venous Thrombosis Pulmonary Embolism Nianankoro Fomba Hospital Ségou

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Cardio-Renal Syndrome: Epidemiological Aspect in the Medicine Department of Tombouctou Hospital

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World Journal of Cardiovascular Diseases 2022年第2期12卷 123-132页

作者： Bassirima Traore Samba Sidibé Souleymane Mariko Karamoko Kantako Massama Konaté Kalifa Diallo Nouhoum Diallo mariam sako Abdoul Karim Sacko Youssouf Kassambara Ichaka Menta Souleymane Coulibaly Department of Medicine Tombouctou Hospital Tombouctou Mali Cardiology Department of the Point G University Hospital Bamako Mali Cardiology Department Mali Hospital Bamako Mali Cardiology Department CHU Gabriel TOURE Bamako Mali

Introduction: Cardio-renal syndrome is a pathophysiological disorder of the heart and kidneys in which chronic or acute dysfunction of one can lead to chronic or acute dysfunction of the other. The objective of this study was to determine the prevalence of cardio-renal syndrome in the Medical Department of the Tombouctou Hospital in Mali. Methods: It is about a descriptive transversal study carried out over 18 months, from January 01st, 2020 to June 30th, 2021 and relating to the analysis of 75 files of patients hospitalized for heart failure and with impaired renal function. Results: The frequency of cardio-renal syndrome was 6.4% with a predominance of men (sex ratio: 2). Hypertension was the most widely described risk factor (50.6%). The history was dominated by chronic heart failure (14.6%) and diabetes (6.6%). The average age was 58 with extremes of 18 and 90. The main aetiologies were dilated cardiomyopathy (46.6%) and ischemic heart disease (20%). Symptoms were dominated by dyspnea (90.6%) and edema of the lower limbs and face (74.6%) accompanied by cough (74.6%). Anemia was noted in 15 patients (20%). The mean clearance (MDRD) was at 32 ml/min. Doppler echocardiography found left ventricular dilation (66.6%), lower left ventricular systolic fraction (64%) and kinetic abnormalities (20%). The kidney ultrasound performed in 9 patients returned to normal in 8 cases and in 1 patient the kidneys were small. Eight deaths (10.6%) were noted. Conclusion: Cardio-renal syndrome is a common feature in which mixed failure is observed in the unfavorable course of heart disease and nephropathy. Its prevalence is unfortunately under evaluated in cardiological settings in Africa and particularly in Mali, hence the interest of a more advanced study.

关键词： Cardio-Renal Syndrome Epidemiology Tombouctou Hospital

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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 made management difficult.

关键词： Pulmonary Embolism Aortic Dissection CHU Kati

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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

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Epidemiology and Management of Heart Failure in the Medicine Department of Tombouctou Hospital

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World Journal of Cardiovascular Diseases 2023年第3期13卷 105-113页

作者： Bassirima Traoré Souleymane Mariko Samba Sidibé Karamoko Kantako mariam sako Massama Konaté Nouhoum Diallo Abdoul Karim Sacko Kalifa Diallo Youssouf Kassambara Djibril Kassogue Oumar Ongoiba Oumar Sanogo Ichaka Menta Souleymane Coulibaly Department of Medicine Tombouctou Hospital Tombouctou Mali Department of Cardiology Point G University Hospital Bamako Mali Department of Cardiology Mali Hospital Bamako Mali Department of Cardiology CHU Gabriel TOURE Bamako Mali

Introduction: Heart failure is a complex syndrome and very frequently observed and secondary to the outcome of many advanced heart diseases. It is made up of a set of symptoms that reflect the tissue and visceral consequences of heart failure. The objective was to determine the hospital prevalence and to describe the management of heart failure in the medical department of Tombouctou hospital in Mali. Methods: This is a descriptive cross-sectional study with retrospective data collection, carried out over 24 months and involving the analysis of 266 records of patients hospitalized for heart failure. Results: The frequency of heart failure was 17.6% with a female predominance. The average age was 48 years with extremes of 16 and 90 years. Cardiovascular risk factors were dominated by high blood pressure with 38%. Global heart failure was the mode of discovery in 72.2% of cases. The etiologies were dominated by hypertensive dilated cardiomyopathy in 36.8% and peripartum cardiomyopathy in 32% of cases. The majority of our patients benefited from diuretic treatment, i.e. 95.9% frequency;with a favorable evolution in 96.2% of cases. We recorded 10 deaths, i.e. a lethality of 3.7%. We report some difficulties encountered during our security study because Tombouctou is a war zone and the lack of a technical platform for biology such as (BNP or NT-proBNP). Conclusion: Heart failure is a real public health problem. Its prevalence is increasing due to the aging of the population and especially the poor management of arterial hypertension in our context.

关键词： Heart Failure Epidemiology Etiology Treatment Tombouctou Hospital

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Heart Disease Scleroderma Revelators: About a Clinical Case

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World Journal of Cardiovascular Diseases 2023年第9期13卷 578-585页

作者： Coumba Thiam Boubacar Sonfo Youssouf Camara Asmaou Keita mariam sako Békaye Traoré Djeneba Koné Mamadou Touré Massama Konaté Hamidou Oumar Bâ Ibrahima Sangaré Sanoussi Daffe Daouda Fofana mariam Cheick Traoré Boureima Dembélé Boubacar Diarra Hamidou Camara Samba Sidibé Souleymane Coulibaly Ichaka Menta Ousmane Faye Department of Cardiology Kati University Hospital Kati Mali Department of Cardiology The Mother-Child University Hospital Bamako Mali Department of Cardiology CHU Point G Bamako Mali Department of Cardiology The CHU Gabriel Touré Bamako Mali Dermatology Hospital of Bamako Bamako Mali Department of Internal Medicine Mali Hospital Bamako Mali

Scleroderma (or systemic sclerosis) is a disease characterized by abnormalities in the functioning of small blood vessels and the immune system, ultimately leading to inflammation and excessive fibrosis of the skin and various organs, including the heart. Management must be multidisciplinary, to avoid complications that are often serious. We report the case of a 20-year-old patient with no known cardiovascular history who consults for dyspnea, and retrosternal pain associated with a dry cough. On physical examination, she had tachycardia, swelling of the lower limbs, jugular turgidity, and deafening heart sounds. Cardiac Doppler ultrasound shows dilation of the right cavities, paradoxical septum and significant pulmonary arterial hypertension, pericardial effusion of medium abundance. On oral examination, it presents an ulceration of the lips, dermatological examination finds scattered hypo chromic spots in the body, more accentuated in the face. Before the hypo chromic dermatosis, a dermatological consultation was carried out with an autoimmune assessment that came back positive for systemic scleroderma.

关键词： Heart Failure Scleroderma Young Subject

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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

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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 50% of its previous level (81.5% of patients).

关键词： Acute Coronary Syndrome Thrombolysis CHU Las Tunas Cuba

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