La super hypertension artérielle en milieu cardiologique au Burkina Faso

Super hypertension is defined as systolic BP ≥ 250 mmHg and/or diastolic BP ≥ 150 mmHg in presence or not of complications. The aim of our study was to describe the epidemiological and evolutive patterns of super hypertension in the cardiology department of the Yalgado Ouedraogo University Hospital. It was an observation cohort over a period of 26 months (July 2011 to August 2013). We recruited 34 patients, corresponding to a prevalence of 12.9% of all hypertensive patients. The median time of follow-up was 7.1 months. The mean age was 47 years old, with a sex-ratio of 1.3. Twenty-one (62%) of the patients were known hypertensive, out of who 24% were regularly rewiewed, 57% on treatment, but none was on regular medications. Dyspnoea was the reason for consulting in 38% of the cases. We noticed a fundoscopy stage III or IV in 55.9% of the cases. All patients had left ventricular hypertrophy on ECG, and 90% on echocardiography. Complication was noticed on admission in 91% of the cases. Chronic renal failure occured in 14.7% of the cases during follow-up, and overall mortality rate was 0.5 person years. Probability of survival over one month was 70% for all patients. The mean age of deceased was 35%. Presence of renal failure, unknown hypertension, and age < 45 were factors linked to death (P < 0.05). Super hypertension is a pathology of the youth, with high morbi-mortality. The prevention is done through early detection and efficient management of hypertension.     

Stigma as a barrier to health care utilization among female sex workers and men who have sex with men in Burkina Faso

Purpose

The aim of this study is to examine the prevalence and correlates of perceived health care stigma among female sex workers (FSWs) and men who have sex with men (MSM), including other stigma types, suicidal ideation, and participation in social activities.

Epidemiological and clinical features,ultrasound findings and prognosis of right-sided infective endocarditis in a teaching hospital in Ouagadougou

Introduction

Right-sided infective endocarditis is rare. It accounts about 5 to 10% of all infective endocarditis cases and is prevalent in patients with congenital heart disease, intravascular devices and drug addiction. Our study aimed to describe the epidemiological, clinical and echocardiographic characteristics of right-sided endocarditis and evaluate the prognosis after treatment.

Methods

From January 2010 to December 2011 we recruited all patients admitted to Yalgado Ouedraogo Teaching Hospital for infective endocarditis, and selected those who had a right-sided location. The Duke criteria were used for diagnosis. We analysed entry points and underlying heart disease. The causative organisms were tracked using blood sample cultures. Ultrasound characteristics were described, and treatment and prognosis were evaluated. Patients’ follow up was conducted from recruitment to 30 June 2012.

Results

In the two-year period, 14 cases of right-sided infective endocarditis were recorded, including seven cases in children. They accounted for 29.1% of all infective endocarditis cases. The mean age was 25.5 ± 12.5 years (range 9–80 years). The venous route was implicated in 12 cases (85.7%). Blood cultures were positive in 11 patients. The bacteria isolated were Streptococcus pneumonia in six cases, Staphylococcus aureus in three and Hemophilus influenza in two cases. HIV status was positive in three patients. Underlying heart diseases were dominated by congenital heart disease in six cases and peripartal cardiomyopathy in four others. Vegetations were located in the right heart in only 11 cases. With antibiotic treatment, a lowering of temperature was shown within an average of 10 days of follow up. Two fatalities were reported.

Conclusion

This study showed that right-sided endocarditis is common in our clinical practice. This infection was prevalent in patients with congenital heart disease or peripartal cardiomyopathy in our context, and the venous route seemed to be the main entry point.     

Left ventricular hypertrophy in hypertensive African blacks: echocardiographic study of 452 patients

OBJECTIVE: The aim of this study was to define in a population of hypertensive Black African, the frequency of left ventricular hypertrophy (LVH), the different kind of LVH, and the factors of LVH occurring. METHODS: Clinical and echographic (according to Penn convention) data was collected in 452 consecutive hypertensive patients (193 women and 259 men). LVH was defined as an indexed left ventricular mass (ILVM) > 134 g/m2 in man and 110 g/m2 in woman. RESULTS: The mean systolic blood pressure was 187 mmHg, and the mean diastolic, 111 mmHg. The mean ILVM was 135.25 g/m2. LVH was present in 53.3% of the patients. Concentric LVH represented 48.5%, eccentric LVH 41.1%, and asymmetric hypertrophy of the septum, 10.4%. LVH increased with patient's age (p = 0.008), hypertension severity (p = 0.0001), and the ancientness of the hypertension (p = 0.0001). CONCLUSION: LVH is frequent in hypertensive black African, and concentric LVH is the most frequent kind of LVH. Factors of LVH occurring are patient's age, severity and the ancientness of the hypertension.     

Efficacy of cibenzoline in a case of atrial fibrillation due to cardiac thyrotoxicosis

The authors report a case of reduction of thyrotoxicosis-related atrial fibrillation by cibenzoline. The initial clinical features of heart failure rapidly resolved and the echocardiographic left ventricular shortening fraction returned to normal. Cibenzoline could be used as antiarrhythmic treatment in atrial fibrillation related to thyrotoxicosis.