Abstract: Introduction: We aimed to describe epidemiological, diagnostic, therapeutic aspects of aortic dissection (AD) managed at the CNHU-HKM of Cotonou (Benin). Methods: It was a retrospective study from january 2018 to july 2023. All patients admitted for AD were enrolled. AD was classified as type A and type B according to Stanford. DA risk factors, socio-demographic characteristics and DA characteristics were studied. Results: Of the 2883 patients admitted during the study period, there were 17 cases of AD, representing a frequency of 0.6%. The mean age was 52 ± 9 years, and the sex ratio was 3.25. Uncontrolled hypertension was the predominant risk factor (88.3%). The main manifestations of AD were chest pain (100%) and aortic insufficiency (52.94%). Chest X-rays showed enlargement of the mediastinum in all patients. Echocardiography showed intimal flap in 62.5%. The aortic angiotomodensitometry, identified 12 type A (70.59%) and 5 type B (29.41%) of AD. Surgical or endovascular treatment was performed in 6 (35.29%) patients. Lethality rate was 47.06%. Conclusion: Aortic dissection was frequent at the teaching clinic of cardiology of CNHU-HKM of Cotonou. Surgical or endovascular treatment wasn't often available, and mortality was high. Prevention of this condition must be the rule, and it requires adequate management of hypertension, which is the most common risk factor.
Abstract: Introduction: We aimed to describe epidemiological, diagnostic, therapeutic aspects of aortic dissection (AD) managed at the CNHU-HKM of Cotonou (Benin). Methods: It was a retrospective study from january 2018 to july 2023. All patients admitted for AD were enrolled. AD was classified as type A and type B according to Stanford. DA risk factors, soc...Show More
Abstract: Introduction: Coarctation of the aorta, a non-cyanogenic congenital heart disease, is a cause of arterial hypertension in young persons, most often managed surgically. We report three cases of coarctation of the aorta in adults operated on at the CNHU-HKM in Cotonou (Benin). Case presentation: our three patients were male with a mean age of 23.3 years. Arterial hypertension of the thoracic limbs with hypotension of the pelvic limbs and a decrease in pelvic limb pulses was the clinical presentation observed. All three patients were diagnosed by transthoracic cardiac echocardiography. On thoracic angioscanner, the location was isthmic in all cases. They all underwent surgical resection of the coarctation, with restoration of aortic continuity by interposition of a Dacron prosthetic graft. Post-operative complications included immediate post-operative grade 3 hypertension, one case of chylothorax, one case of pleuropneumopathy and one case of post-operative hemorrhage. At one year, grade 1 hypertension persisted in one patient. Conclusion: Coarctation of the aorta can be successfully operated in Benin. Post-operative follow-up must be meticulous, in search of residual hypertension.
Abstract: Introduction: Coarctation of the aorta, a non-cyanogenic congenital heart disease, is a cause of arterial hypertension in young persons, most often managed surgically. We report three cases of coarctation of the aorta in adults operated on at the CNHU-HKM in Cotonou (Benin). Case presentation: our three patients were male with a mean age of 23.3 ye...Show More
Abstract: Background: Myocardial infarction with non-obstructive coronary arteries (MINOCA) remains a puzzling clinical entity characterized by clinical evidence of myocardial infarction (MI) with normal or near-normal coronary arteries on angiography (stenosis <50 %). This pathology is poorly understood, several studies are underway for a better understanding of this disease. The aim of our work was to review the literature and assess the epidemiology, clinical features, prognosis and etiologies of MINOCA. Methods and Results: Descriptive, prospective study, spread over a period of 36 months from January 2018 to December 2020 involving a total number of 585 patients undergoing coronary angiography at the cardiology department of CHU Tlemcen, for a reason for acute myocardial ischemia. We defined the patients as having acute myocardial ischemia with obstructive coronary artery disease (MI-CAD) if there was revascularization or plaque ≥ 50% and as having MINOCA if there was <50% obstruction or a mechanism without plaque. Patients who received thrombolytics before angiography were excluded. We studied the epidemiological, clinical and prognostic profile of the MINOCA population then compared them to patients with obstructive coronary artery disease and finally we established an etiological analysis of the MINOCA population. The number of MINOCA cases in our sample of 585 AMI patients was 10.25% vs. 525 (89.74%) cases of AMI-CO, it was more common in men (78.3% vs. 21, 7%; odds ratio at 3.61) and in the youngest patients. MINOCA patients were more likely to be without traditional cardiac risk factors (7.9% vs. 2.1%; P <0.001) but more predis¬posed to non-traditional risk factors than AMI-CO patients (3.7% against 1.8%; P = 0.026). Smoking is the only traditional risk factor frequent in the MINOCA population versus MI-CAD (P at 0.001). Depression, stress, drug addiction, DVT history and autoimmune disease history are more frequent in the MINOCA population versus MI-CAD (P <0.05). STEMI are more found in the MINOCA population versus MI-CAD (P = 0.000). In terms of prognosis, the MINOCA population had a better prognosis: less risk of recurrence than the MI-CAD population 6.7% versus 10.45% (P = 0.03) also less mortality 0% versus 4.6% (P = 0.007). Conclusions: The patients with MINOCA were more men, smokers, depressed, stressed, drug addicts with hypercoagulable states compared to patients with obstructive coronary artery disease (MI- CAD) however they had a better quality of life and a good prognosis.
Abstract: Background: Myocardial infarction with non-obstructive coronary arteries (MINOCA) remains a puzzling clinical entity characterized by clinical evidence of myocardial infarction (MI) with normal or near-normal coronary arteries on angiography (stenosis <50 %). This pathology is poorly understood, several studies are underway for a better understanding of this disease. The aim of our work was to review the literature and assess the epidemiology, clinical features, prognosis and etiologies of MINOCA. Methods and Results: Descriptive, prospective study, spread over a period of 36 months from Januar...Show More
