Archives des maladies du coeur et des vaisseaux
-
The increasing prevalence of cardiovascular diseases in subsaharan Africa and their related mortality and morbidity have been established. A large number of them present as emergencies. The purpose of this first multicentric study was to assess the causes, management and outcome of cardiovascular emergencies in savannah and forest environments. ⋯ Compared with patients from western countries, the African patients are younger because some diseases affect young people like rheumatic heart disease or postpartum and infectious cardiomyopathies. The difficulties to reach health care facilities made the outcome more severe. Hypertension and valvular heart disease deserve priority in preventive strategy. Cardiomyopathies have to be studied to precise their causes. Finally, the management of cardiovascular emergencies needs a special care in the hospitals owing to their increasing frequency and their severity.
-
Arch Mal Coeur Vaiss · May 2006
Case Reports[Unusual outcome of mitral valve infectious endocarditis in a premature infant].
The authors report a case of Staphylococcus Aureus infectious endocarditis in a premature baby. Echocardiography on the 8th day of life showed a large vegetation on the anterior mitral leaflet without significant regurgitation. Intravenous antibiotics and platelet antiaggregant therapy were given. ⋯ At one month, the development of severe mitral regurgitation led to surgical valvuloplasty in a 2 kg neonate, the vegetation on the foramen ovale having spontaneously fragmented. The ablation of the mitral vegetation associated with commissuroplasty reduced the mitral regurgitation. At 3 months after surgery, the child was asymptomatic with a minimal mitral regurgitation.
-
Arch Mal Coeur Vaiss · May 2006
Case Reports[Fulminant influenza type A associated myocarditis: a fatal case in an 8 year old child].
Fulminant Influenza type A-associated myocarditis are very rare in children. The clinical presentation is non specific, like flu illness, cardiogenic shock or sudden cardiac arrest. ⋯ The aim of this observation is to remind that influenza in children, usually considered as a benign illness, can exceptionally be complicated by a fulminant myocarditis. Because the possibility to recover a full myocardial function, the persistence of severe heart failure despite the medical treatment should conduct rapidly to a mechanical circulatory assistance.
-
Arch Mal Coeur Vaiss · Mar 2006
Comparative Study[Type B natriuretic peptide (BNP) versus n-terminal type B natriuretic propeptide in the diagnosis of cardiac failure in the elderly over 75 population].
Type B natriuretic peptide (BNP) versus n-terminal type B natriuretic propeptide in the diagnosis of cardiac failure in the elderly over 75 population The value of BNP is well established in the diagnosis of cardiac failure in cases of dyspnoea in the emergency room in young and, more and more, in elderly subjects. However, there are few studies comparing the diagnostic value of BNP and of the n-terminal pro-BNP in patients over 75 years of age. The aim of this study was to compare the diagnostic value of BNP and NT-pro BNP in dyspnoea of the elderly patient. ⋯ A BNP value of 300 pg/ml had the same sensitivity and specificity as an NT-proBNP of less than 1 500 pg/ml. A BNP of less than 200 pg/ml and an NT-proBNP of less than 1 000 pg/ml had excellent negative predictive values for excluding the diagnosis of cardiac failure. The authors conclude that the BNP and NT-proBNP are useful for the diagnosis of cardiac failure in acute dyspnoea of the elderly and seem to have a comparable diagnostic value.