Cardiovascular Journal of Africa: Vol 30 No 2 (March/April 2019)

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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 30, No 2, March/April 2019 AFRICA e1
Cardiovascular Topics
Acute circulatory failure in two cardiology departments
in Dakar: 44 cases
ND Gaye, AA Ngaidé, SCT Ndao, I Dongmo, SA Sarr, F Aw, JS Mingou, M Bodian, MB Ndiaye,
A Mbaye, M Sarr, M Diao, SA Ba
Abstract
Introduction: Acute circulatory failure is a life-threatening
emergency whose prognosis depends on early management
and aetiological diagnosis. The aim of our study was to assess
the epidemiological, aetiological, therapeutic and prognostic
aspects of acute circulatory failure in two cardiology depart-
ments in Dakar.
Methods: This was a longitudinal, multicentre, descriptive
study over a period of six months fromOctober 2014 toMarch
2015. We included all patients with acute circulatory failure
(systolic blood pressure < 90 mmHg, oligoanuria, tachy-
cardia, tachypnoea, onset of altered consciousness) either on
admission or during hospitalisation during the study period.
A long-term survival survey (six months to one year) was
conducted on all included patients.
Results: Forty-four patients were enrolled. The average age
was 54.9 years, ranging from 20 to 83 years. The gender ratio
was 1.1. Acute circulatory failure occurred most often during
hospitalisation (63%), with known cardiomyopathy in 47.7%
of cases. Consciousness was impaired in 11 patients while
oligoanuria was present in 27.3% of cases. Inflammatory
syndrome was mostly found in 63.6% of cases and renal
insufficiency and acute liver failure were reported in 45.5 and
29.5% of patients, respectively. Left ventricular dysfunction
was the most common echocardiographic feature (70%).
Acute circulatory failure was cardiogenic in most cases, with a
predominance of advanced dilated cardiomyopathy (44.9%).
Septic shock was found in 25% of patients, with pulmonary
infection as the main location (20%). Nine per cent of patients
had hypovolaemic shock. The most used inotropic drug was
dobutamine in 79.5% of cases, followed by adrenaline (18.2%)
and norepinephrine (4.5%). Intra-hospital mortality rate was
high (52.3%) and one-year survival rate was 27.2%. Poor
prognostic factors such as advanced age and renal impair-
ment were associated with a higher overall mortality rate of
18 to 90%, with no statistical significance.
Conclusion: Acute circulatory failure is a diagnostic and
therapeutic emergency with a high mortality rate.
Keywords: acute circulatory failure, epidemiological, prognostic,
cardiology, Dakar
Submitted 4/11/16, accepted 5/12/18
Cardiovasc J Afr 2019; 30: e1–e6
DOI : 10.5830/CVJA-2018-073
Service de cardiologie, Hôpital Aristide Le Dantec, Dakar,
Sénégal
ND Gaye, MD,
SCT Ndao, MD
I Dongmo, MD
SA Sarr, MD
F Aw, MD
JS Mingou, MD
M Bodian, MD
MB Ndiaye, MD
M Sarr, MD
M Diao, MD
SA Ba, MD
Service de cardiologie, Hôpital Général de Grand Yoff,
Dakar, Sénégal
AA Ngaidé, MD
A Mbaye, MD