AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 16 MODERATED POSTER SESSION 1 Submission ID: 992 A RARE COMPLICATION OF BEHÇET’S DISEASE. A CASE REPORT Houssem Thabet, Marwen Kacem, Rym Gribaa, Ayoub Meddeb, Hela Kaddour, Saeb Ben Saad, Mehdi Slim, Sami Ouannes, Sameh Ben Farhat, Aymen Hraiech, Imen Ben Ali, Elyes Neffati Cardiology Department, Sahloul Sousse University Hospital, Tunisia Background: Behçet’s disease is a systemic disease, which mainly affects young people in Mediterranean countries.Cardiac involvement is rare, its prevalence varies from 1 to 6% in clinical series, it can affect the three tunics of the heart.Coronary artery disease is the most severe heart attack. Case presentation: We report the case of a 32-year-old man with no previous family and personal history. He went to the emergency room for atypical chest pain. His ECG showed a regular sinus rhythm, with no disturbance in repolarization.The physical examination was normal. US troponins was elevated at 5000.A TTE was performed showing good systolic function of the LV, the segmental kinetics were homogeneous,with absence of valve disease and a dry pericardium. The patient was admitted to cardiology, a coronarography done was normal except the diagonal which was the site of multiple aneurysm lesions.During his hospitalisation,the patient presented an osteonecrosis of the left femoral head.Behcet’s disease has been evoqued and then confirmed.The patient was transferred to Submission ID: 994 CLINICAL CHARACTERISTICS OF PATIENTS PRESENTING WITH EARLY IN-STENT RESTENOSIS AND MID-TERM OUTCOMES AFTER REVASCULARIZATION Ghariani Anis, Fekih Romdhane Ahmed, Ben AbdessalemMohamed Aymen, Cheikh Sideya Khalil, Ben Ameur Zied, Mosrati Hamza, Bouraoui Hatem, Mahdhaoui Abdallah, Jeridi Gouider Cardiology Dpt, UHC Farhat Hached, Tunisia Introduction: The mechanism and characteristics of early in-stent restenosis (ISR) is not fully elucidated. Whether there are different clinical characteristics and outcomes among patients presenting with early and late ISR remains to be clarified. In our study, we aimed to compare clinical characteristics of patients presenting with early and late ISR and to describe outcomes following revascularization Methods: A total of 116 patients who underwent initial stent implantation in our hospital, and then were readmitted to receive treatment for the reason of recurrent ISR From January 2017 to December 2018 were involved. The patients were categorized as early ISR (≤6 months; n = 30) and late ISR (>6 months; n = 86). They were followed-up for a mean period of 24 months. During follow up, major adverse cardiac events (MACEs) included cardiac death, non-fatal myocardial infarction (MI), or target lesion revascularization (TLR) were collected. Results: Most baseline characteristics were almost similar in both groups except for hypertension and treatment with statins. The group of early ISR were more hypertensive (60% vs 41.2%, p=0.004) and received less frequently full dose of statin (3.3% vs 24%, p<0.001). The incidence of MACEs is higher in the early ISR group (18.1% vs 6.4%; p=0.042). A daily dose of statin under the full dose was predictor of worse outcomes following revascularization (75% vs 19%, p=0.005). Conclusion: Our study suggests that Early ISR is associated with more MACEs during the mid-term follow-up period. The LDL-cholesterol levels may be related to the formation and progression of early neoatherosclerosis. This may explain that statins under the full dose is associated with worse outcomes following ISR treatment in the early ISR group. Submission ID: 991 AN EXCEPTIONAL CAUSE OF CHRONIC CHEST PAIN Houssem Thabet, Marwen Kacem, Rym Gribaa, Ayoub Meddeb, Hela Kaddour, Saeb Ben Saad, Mehdi Slim, Sami Ouannes, Sameh Ben Farhat, Aymen Hraiech, Imen Ben Ali, Elyes Neffati Cardiology Department, Sahloul Sousse University Hospital, Tunisia Background: Papillary fibroelastoma is a benign, primary, and very rare cardiac tumor with a preferential valve location (77% of cases). The aortic valve is the most affected (30% of cases) followed by the mitral valve (20-25% of cases). Although fibroelastoma affects all age groups from the neonatal period to the tenth decade of life. Sometimes asymptomatic, it can be the cause of serious embolic events. Case presentation: We report the case of a 59-year-old patient with a history of diabetes, hypertension, unmatched sleep apnea syndrome, and an ischemic stroke that was not sequelae one year ago. She consulted the emergency room for atypical chest pain that had progressed for a year without other associated clinical signs. The clinical examination was unremarkable. The ECG showed a regular, sinus rhythm as well as an incomplete left bundle branch block. Troponins were negative. We completed with an echocardiogram which revealed a rounded, well-defined, mobile mass of tissue echogenicity measuring 13 mm long, at the expense of the aortic wall. The aortic valve was neither leaky nor stenosing, and the left ventricule systolic function was correct. Besides, there were no other anomalies. The infectious investigation was negative. We completed by a cardiac scanner which confirmed the fibroelastoma. The CT scan showed permeable coronary arteries. We opted for surgical resection of the tumor but the patient refused surgery. Currently, one year after the discovery of this benign tumor, the patient reported atypical precordialgia. Conclusion: Currently, the diagnosis is easily suggested by echocardiography and computed tomography. The diagnostic confirmation remains anathomopathological. Its treatment is surgical by excision of the tumor. The long-term prognosis is good. the internal medicine department for further management.1 year later, the patient consulted for tightness-type chest pain occurring at rest,intermittent,lasting 30 min,associated with dyspnea at rest. Physical examination revealed isolated polypnea at 22 cpm.In biology:BC = 10,000.CRP = 150 US Troponins = 14000.The ECG was normal.Chest x-ray revealed a convex left middle arch filled with a water-toned mass.TTE found good systolic LV function. As well as the presence of an aneurysm formation of 51 mm of long axis, the origin of which would be a branch of the left coronary artery, deforming the lateral wall of the LV and pushing back the pulmonary trunk and the left PA without creating a real obstacle. Coronary angiography was then performed showing a large partially thrombosed sacciform aneurysm of IVA I with a circulating lumen at 3 cm and a neck of 4 mm.2 micro-aneurysms at the level of the distal part of the 2nd diagonal of 4 and 3 mm.The distal Cx was occluded.The patient received solumédrol then relayed by oral corticosteroids associated with imurel.The medico-surgical staff opted for resection of the coronary aneurysm with a coronary artery bypass grafting.Which were realised with succes. Conclusion: Behçet’s disease is a vasculitis of varying expression.Cardiac involvement remains rare.The interest of our clinical presentation is its peculiarity in the difficulty of management.
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