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Echocardiographic Abnormalities in Hemodialysis Patients in Togo
Kossi Akomola Sabi,
Eyram Makafui Yoan Yawo Amekoudi,
Abalo Mario Bakai,
Badomta Dolaama,
Tcherou Tchaa,
Borgotia Atta,
Yawovi Mawufemo Tsevi,
Machihude Pio
Issue:
Volume 7, Issue 4, December 2023
Pages:
70-74
Received:
29 August 2023
Accepted:
18 September 2023
Published:
8 October 2023
Abstract: Cardiovascular diseases (CVD) are a common complication among patients with end-stage chronic kidney disease (CKD). They represent the leading cause of mortality in hemodialysis patients. In a resource-limited setting, our objective was to assess echocardiographic aspects in chronic hemodialysis patients through a case series study conducted over a 24-month period, from January 2019 to December 2020. We included all patients who had been undergoing iterative hemodialysis sessions for at least 6 months and had undergone at least one cardiac ultrasound in the nephrology department. In total, 79 patients were enrolled, with an average age of 47.5 years and a sex ratio of 0.93. Hypertension (HTN) was observed in 84.8% of patients, and obesity was present in 39.2%. The main structural abnormalities included left ventricular hypertrophy (LVH) in 64.6% of cases and dilatation in 36.7% of cases. Left atrial (LA) and right atrial (RA) dilatations were observed in 36.7% and 15.2% of cases, respectively. Cardiac valve lesions observed were primarily calcifications. Echocardiography, a readily accessible non-invasive medical imaging technique, revealed a high prevalence of LVH and signs of inadequate dialysis in our population.
Abstract: Cardiovascular diseases (CVD) are a common complication among patients with end-stage chronic kidney disease (CKD). They represent the leading cause of mortality in hemodialysis patients. In a resource-limited setting, our objective was to assess echocardiographic aspects in chronic hemodialysis patients through a case series study conducted over a...
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Research Article
The Impact of Common Comorbidities on the Cardiopulmonary Rehabilitation Outcomes and Cost of Care for Post-CABG Surgery Patients
Mohammed Takroni,
Collins Ogbeivor,
Nargis Mirza,
Mohammed Al-Subaie,
Mohammed Al-Zahrani
Issue:
Volume 7, Issue 4, December 2023
Pages:
75-81
Received:
18 September 2023
Accepted:
10 October 2023
Published:
28 October 2023
Abstract: Background: The incidence of coronary Heart Disease (CHD) has increased globally, including in Saudi Arabia. Consequently, the use of coronary artery bypass graft (CABG) surgery, one of the most valuable solutions, has also increased. Common comorbidities (CMs) such as diabetes mellitus (DM), hypertension (HTN), peripheral vascular disease (PVD), chronic obstructive pulmonary disease (COPD), peptic ulcer disease, dialysis-dependent renal failure, and obesity have been reported to adversely affect rehabilitation outcomes, increase hospital length of stay (LOS), and increase the cost of care for post-CABG surgery patients. Despite these facts, no previous studies have assessed the effect of comorbidities on Cardiac Rehabilitation outcomes, cost of care, and length of hospital stay in post-CABG surgery patients in the Saudi Population. Objective: To assess the effect of cardiac comorbidities on the outcomes of CR intervention in CABG patients and examine how these comorbidities affect the length of stay in the intensive care unit (ICU) and hospital, as well as the cost of care. Methods: A retrospective cohort study was conducted to follow-up post-CABG patients over two years, from 2020 to 2022. A total of 62 male and female patients who met the inclusion criteria were included in this study. The subjects were divided into two groups based on the CM size. Group I consisted of patients with (> 4 CMs), whereas Group II consisted of patients with (<3 CMs). Results: Group I had a higher mean score of comorbidities (CMs) at 5.09 ± 2.43, which resulted in longer stays in the ICU at 4.34 + 2.24 and in the hospital at 9.16 + 4.63 compared to Group II at 3.43 ± 1.48 and 7.2 ± 1.47, respectively. Group II had higher total cost of care. Conclusions: This study found that patients with multiple comorbidities such as DM, HTN, and dyslipidemia had longer hospital and ICU stays and higher care costs.
Abstract: Background: The incidence of coronary Heart Disease (CHD) has increased globally, including in Saudi Arabia. Consequently, the use of coronary artery bypass graft (CABG) surgery, one of the most valuable solutions, has also increased. Common comorbidities (CMs) such as diabetes mellitus (DM), hypertension (HTN), peripheral vascular disease (PVD), c...
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Research Article
Electrocardiographic and Echocardiographic Abnormalities, and Cirrhotic Cardiomyopathy in Patients Hospitalized at the Campus University Hospital (Lomé)
Komlavi Yayehd*,
Tchaa Tcherou,
Mawuli Laté Lawson-Ananissoh,
Agossou Defodji,
Eyana Tchoua,
Soulemane Pessinaba,
Wiyaou Dieudoné Kaziga,
Soodogoua Baragou,
Aklesso Bagny,
Findibe Damorou
Issue:
Volume 7, Issue 4, December 2023
Pages:
82-87
Received:
8 October 2023
Accepted:
27 October 2023
Published:
9 November 2023
Abstract: Cirrhotic cardiomyopathy is a constellation of structural and functional cardiac abnormalities in patients with liver cirrhosis, apart from any underlying cardiac pathology, which potentially worsens the prognosis of these patients. The objectives of this study were to describe electrocardiographic and echocardiographic abnormalities in cirrhotic patients and estimate the prevalence of cirrhotic cardiomyopathy. This is a cross-sectional study with prospective data collection, carried out in hepato-gastroenterology department of the Campus University Teaching hospital of Lomé between July and December 2019, in adult patients hospitalized for liver cirrhosis. Of the 32 patients (men: 62.5%, mean age: 53.3 ± 13.5 years), the main causes of cirrhosis were viral hepatitis (40.6%) and alcoholic cirrhosis (25 %). Cirrhosis was classified Child-Pugh C in 62.5% of patients. The most common electrocardiographic abnormalities were prolonged QTc (59.4%), sinus tachycardia (31,2%), left atrial hypertrophy (25%) and left ventricular hypertrophy (12.5%). The main echocardiographic abnormalities were high cardiac output (68.8%) and left ventricular diastolic dysfunction (56.3%). The diagnostic criteria for cirrhotic cardiomyopathy were met in 37.5% of cases and it was more frequent in Child-Pugh C patients (66.7%) and in cirrhosis of alcoholic etiology (33.4%). Whatever the etiology of cirrhosis, electrocardiographic and echocardiographic abnormalities were common. The prevalence of cirrhotic cardiomyopathy was high, hence the need for systematic cardiological assessment in these patients.
Abstract: Cirrhotic cardiomyopathy is a constellation of structural and functional cardiac abnormalities in patients with liver cirrhosis, apart from any underlying cardiac pathology, which potentially worsens the prognosis of these patients. The objectives of this study were to describe electrocardiographic and echocardiographic abnormalities in cirrhotic p...
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Research Article
Prognostic Factors in Patients with Chronic Heart Failure at the Maroua Regional Hospital, Cameroon
Jérôme Boombhi*,
Liliane Mfeukeu-Kuaté,
Honoré Kemnang,
Rékia Mahamat,
Moustapha Seni,
Amalia Owona,
Pierre Mintom,
Guillaume Ebene Manon,
Alain Menanga
Issue:
Volume 7, Issue 4, December 2023
Pages:
88-92
Received:
27 September 2023
Accepted:
25 October 2023
Published:
17 November 2023
Abstract: Introduction: Heart failure (HF) is a complex and serious condition that greatly impairs the quality of life of patients with high lethality. It is a major public health problem and is the leading cause of hospitalization for people over 60-65 years old. The therapeutic approach of HF has evolved considerably, allowing its prognosis to be improved. The aim of our study was to analyze the evolution of HF and to identify the predictive factors of mortality and re-hospitalization of patients with chronic heart failure at the Regional Hospital of Maroua. Methods: We carried out a prospective analytical study over a period of 8 months at the Maroua Regional Hospital (MRH). All patients followed in cardiology for chronic heart failure were included. Clinical and paraclinical data were collected on admission. The patients were followed for a period of 6 months and the primary study endpoint was the occurrence of cardiac death and/or re-hospitalization for heart failure. Results: The mean age of our patients was 54.5 ± 15.59 years with a male predominance. Arterial hypertension was the main etiology (58.2%) of heart failure. The re-hospitalization rate was 4.1% and the mortality rate was 3.7%. Multivariate analysis revealed three independent mortality factors: Dyspnea stage IV of the NYHA, LVEF<40%, and hemoglobin level less than 12g/dl. Stage IV dyspnea and left ventricular ejection fraction (LVEF) <40% were independent predictors of rehospitalization; Conclusion: In our context, the factors of poor prognosis in patients followed for chronic heart failure are impaired LVEF, NYHA stage IV dyspnea and anemia. In patients with these different factors, close and targeted care should be instituted to reduce morbidity and mortality.
Abstract: Introduction: Heart failure (HF) is a complex and serious condition that greatly impairs the quality of life of patients with high lethality. It is a major public health problem and is the leading cause of hospitalization for people over 60-65 years old. The therapeutic approach of HF has evolved considerably, allowing its prognosis to be improved....
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Report
Pakistani Origin Takayasu Arteritis: A Case Report with a Brief Review from Asymptomatic Presentation Till Diagnosis and Clinical Management
Shahzad Ahmad,
Muhammad Sajjad Ali Khan,
Pardis Bahadori,
Aimal Khan,
Wiqar Ahmad,
Muhammad Ilyas,
Komal Qayyum,
Muhammad Saeed,
Musa Bin Bashir*
Issue:
Volume 7, Issue 4, December 2023
Pages:
93-96
Received:
6 October 2023
Accepted:
23 October 2023
Published:
29 November 2023
Abstract: Takayasu's arteritis is a rare chronic granulomatous vasculitis that primarily affects the aorta and its branches. It is estimated that this disease impacts approximately 2.6 million individuals every year, with a higher prevalence among women in their second or third decade of life. In this case report, we describe the presentation and management of a 22-year-old female patient who initially sought medical attention from a neurologist due to upper and lower back pain. Initially, the patient's symptoms were managed conservatively. However, a few months later, she presented to the medical department with a high-grade fever, syncopal episodes, generalized body aches, and swelling in her right arm. The findings from the computed tomography angiography (CTA) revealed diffuse thickening of the entire thoracic and abdominal aorta's walls, long segment luminal narrowing of the proximal left common carotid artery and left subclavian artery, as well as diffuse thickening of the abdominal aorta's wall. This case highlights the importance of recognizing that Takayasu's arteritis can present in an unusual manner. Early diagnosis and management are crucial steps towards providing appropriate care for patients. Due to the potential involvement of various arterial segments, Takayasu's arteritis can manifest with diverse symptoms and complications. Therefore, clinicians should maintain a high index of suspicion when encountering patients with unexplained symptoms, particularly those involving the aorta and its branches. In conclusion, the presented case emphasizes the need for prompt recognition and intervention in Takayasu's arteritis. By increasing awareness of this rare condition and its atypical presentations, healthcare professionals can ensure timely diagnosis and appropriate management, ultimately improving patient outcomes and quality of life. Further research is warranted to enhance our understanding of this complex disease and optimize its management strategies.
Abstract: Takayasu's arteritis is a rare chronic granulomatous vasculitis that primarily affects the aorta and its branches. It is estimated that this disease impacts approximately 2.6 million individuals every year, with a higher prevalence among women in their second or third decade of life. In this case report, we describe the presentation and management ...
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Case Report
A Case of Acute Type A Aortic Dissection Complicated with High-Altitude Pulmonary Edema
Issue:
Volume 7, Issue 4, December 2023
Pages:
97-100
Received:
26 November 2023
Accepted:
13 December 2023
Published:
26 December 2023
Abstract: We report a case of a 55-year-old middle-aged male patient who developed dyspnea while traveling in a high-altitude region. After further investigations, he was diagnosed with high-altitude pulmonary edema (HAPE). During the treatment process, he was urgently transferred to our hospital due to chest pain, and a computed tomography angiography (CTA) confirmed acute type A aortic dissection (ATAAD). The patient underwent an emergency Bentall procedure, total arch replacement, and descending aortic stent placement. The surgery was uneventful. The postoperative recovery was smooth and the patient was discharged in good condition. ATAAD is a critical condition in cardiac surgery, with a low incidence rate but an increasing trend. It is associated with high mortality rates. Acute pulmonary edema is one of the complications of aortic dissection, possibly related to acute aortic valve insufficiency and the release of inflammatory factors leading to pulmonary capillary damage. Acute pulmonary edema will seriously affect lung function, and the resulting hypoxemia will also lead to hypoxia in tissue cells of organs throughout the body, leading to disorder of the body's internal environment. HAPE refers to the patient who has recently arrived at a plateau (generally above 3,000 meters above sea level) and has difficulty breathing at rest, chest tightness, cough, white or pink foamy sputum, and the patient feels general weakness or reduced mobility. The main pathological change of high-altitude pulmonary edema is extensive alveolar edema distributed in patches, and occasionally the formation of hyaline membranes can be seen (this is caused by fibrin deposition in the alveolar edema fluid). HAPE is a non-cardiogenic pulmonary edema specific to high-altitude regions, with severe conditions and high mortality rates. The current understanding suggests that the mechanism of HAPE involves excessive elevation of pulmonary arterial pressure due to hypoxia, increased pulmonary vascular permeability, impaired pulmonary fluid clearance, fluid retention, and fluid transport imbalance. Acute pulmonary edema is a relatively rare presentation of aortic dissection, and the combination of ATAAD and HAPE is extremely rare, posing additional challenges to surgical treatment and anesthesia management.
Abstract: We report a case of a 55-year-old middle-aged male patient who developed dyspnea while traveling in a high-altitude region. After further investigations, he was diagnosed with high-altitude pulmonary edema (HAPE). During the treatment process, he was urgently transferred to our hospital due to chest pain, and a computed tomography angiography (CTA)...
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