CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 25 AFRICA MODERATED POSTER SESSION 1 Submission ID: 1247 ACUTE CORONARY SYNDROME WITH ELEVATION OF ST SEGMENT IN THE COVID-19 ERA Sarra Soua, Roua chouihi, Haifa Bradai, Dorra Loghmari, Mahdi Zorgati, Mohamed Ouertani, Hajer Bettaieb, Naoufel Chebili SAMU 03 Sahloul, Tunisia Introduction: chest pain is a common motif for consultation. It is known that mortality due to myocardial infraction correlates directly to the time of treatment initiation. The regulation room of our emergency medical service has an essential role in diagnosing myocardial infraction, identifying its potential risk of complication and indicating right therapies with rapid referral to the closet technical platform when indicated. The reperfusion strategy is chosen according to chest pain delay and to catheterization room availability. The aim: To investigate the impact of the third wave of COVID-19 on delays between symptoms’ onset and the first medical contact (FMC)in patients with myocardial infarction with ST segment elevation (STEMI) Materials and Methods: All regulation calls for STEMI during the third wave of COVID-19 were compared to a control group of patients from the same period in 2018 before the pandemic. First, we investigated the difference in SCA incidence between the two periods. Secondly, we compared delays between symptom onset and FMC between the COVID-19 period group and the control group and the same for reperfusion treatment delays. Results: An increase in the overall incidence of ACS was noted during the third wave of the COVID-19 pandemic compared to the control period. Delays between symptom onset and FMC were longer during the COVID-19 period compared to the control period (112 min vs 60 min, p = 0.049) Concerning reperfusion strategies, the prevalence of throbolysed STEMIs was higher during COVID-19 period compared to the control period (40% vs 30%, p?) The prevalence of patients receiving primary angioplasty was higher in the COVID-19 period group (46%) compared to the control group (28.9%). Conclusion: The mean time between symptom onset and FMC was significantly longer during the COVID-19 period compared to the control period. Further investigations are needed for developing policies aiming the improvement of delays in care delivered to patients with STEMI. Submission ID: 1249 INFECTIVE ENDOCARDITIS SECONDARY TO A RESTRICTIVE VENTRICULAR SEPTAL DEFECT Chiraz Lassoued, Kaouther Hakim, Khalil Ouaghlani, Syrine Triki, Houda Ben Arbia, Sana Said, Héla Msaad, Fatma Ouarda Pediatric cardiology department, la Rabta hospital, Tunisia Introduction: Infective endocarditis (IE) secondary to a restrictive ventricular septal defect (VSD) is rarely observed. We report the case of a 15 year-old patient with an underlying congenital restrictive VSD who presented with fever chills and fatigue for 15 days prior to hospitalization. Examination showed a temperature of 38°, a blood pressure of 120/60mmHg, a heart rate of 100bpm, a VSD holosystolic murmur, a respiratory rate of 20 breaths per minute, and an oxygen saturation of 100% in room air. Transthoracic echocardiography (TTE) revealed a large vegetation of 15*12 mm on the right ventricle side with a 5 mm perimembraneous VSD with a left to right shunt. The mitral, aortic, tricuspid, and pulmonary valves were morphologically and functionally normal. The LVEF was normal. The computed tomography confirmed the presence of the vegetation and did not show any secondary locations. Enterococcus spp grew in the blood culture. The patient was put on a triple prolonged intraveinous antibiotic therapy. In our center, we treat no less than two to three patients per year for IE with an underlying restrictive VSD. Although the actual last guidelines do not recommend the closure of restrictive VSD, these hemodinamically insignificant defects can predispose to IE. Hence, interventions should be discussed case by case, to prevent such complications, especially in developing countries with poor socio-economic conditions.
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