CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 29 AFRICA Submission ID: 1016 DETERMINANTS OF RETURN TO WORK AFTER ACUTE CORONARY SYNDROME SKANDER BOUCHNAG, OLFA JLASSI, MEJDI BEN MESSAOUD, NIDHAL BOUCHAHDA, MOHAMEDMAHDI BOUSSAADA, MARWEN MAHJOUB, MAJED HASSINE, FETHI BETBOUT, HABIB GAMRA CARDIOLOGY A DEPARTEMENT - FATTOUMA BOURGUIBA HOSPITAL , MONASTIR - TUNISIA Background: Acute coronary syndrome (ACS) is a serious disorder causing strong anxiety in patients of working age. It is increasingly occurring in younger people. So greater emphasis needs to be placed on this working-age population because of its economic and social implications. Return to work (RTW) has been relatively underestimated over the past decade in favor of more subtle measures of quality of life. Methods: 50 participants were recruited after hospitalization for a first episode of ACS from June 2018 to December 2019. The study population was divided into RTW group (Patients who returned to work within 6 months) and non-RTW group (Patients who did not return to work within 6 months) for comparison of socio-demographic, clinical, occupational and psychosocial characteristics. Results: The mean age was 51.92 ±6.4. the study population was made mainly by men (90%) with no statistical difference between the RTW group and the non-RTW group (p=0.79). 48% were employees and 52% were self-employed. The majority (87.5%) of patients in the non-RTW group were self-employed and 54% of patients in the RTW group were employees. The two groups differed significantly regarding employment status (p=0.05). Manual workers were more frequent than non-manual workers (84 vs. 16%; p=0.079). The mean regular working hours per week was 52.41±18.48 in the RTW group and 64.38 ±18.26 in the non-RTW group (p=0.102). The totality of patients was married and 72% of them had 1 to 3 children in charge. Smoking (76%), Diabetes (43.1%), dyslipidemia (35.3%), and hypertension (37.3%) were the major cardiovascular risk factors in our population. No significant difference was found between the non-RTW group (NSTEMI = 12.5%, STEMI =87.5%) and the RTW group (Unstable angina =7.1% NSTEMI =23.8%, STEMI =69%) according to the admission diagnosis (p=527). Non-RTW group had a significantly higher rate of in-hospital complications than the RTW group (37.5% vs. 7.1%; p=0.044). There was no significant difference between the two groups regarding treatment modalities (p=1). At one, three, and six months, 48%, 68%, and 84% of patients, respectively, returned to work. NSTEMI and STEMI patients had a later RTW compared to UA patients (p=0.229). 64.3% of patients had a full RTW, whereas, 15 patients (35.7%) were the subject of workstation organization. The work organization concerned work time (reduced working hours) (6.7%), work station (33.3%) or both (60%). Submission ID: 1023 DOES A MYOCARDIAL CLEFT SUPPORT THE DIAGNOSIS OF EARLY HYPERTROPHIC CARDIOMYOPATHY IN CASE OF SYNCOPE WITH MINIMAL POSTERIOR HYPERTROPHY? NOAMEN AYMEN, Tlili Ghassen, Mahfoudhi Houaida, Jabloun Taha Yassine, Hajlaoui Nadhem, Fehri Wafa Military hospital of Tunis, Tunisia MODERATED POSTER SESSION 2 Introduction: Myocardial clefts are congenital abnormalities of myocardial fibers described as fascicular disorders in healthy subjects, hypertensives, and in cases of early hypertrophic cardiomyopathy. It is an under diagnosed entity with unknown clinical consequences. Case report: We report the case of a 23-year-old man with no medical history who consulted for syncope causing an occipital head injury. The examination showed an occipital bruise, no orthostatic hypotension, no pause and no drop in blood pressure on carotid sinus massage with an appropriate occulo-cardiac reflex. Cardiopulmonary auscultation was normal. The rest of the exam was without any particularity. EKG was normal. Cerebral CT was normal. TTE shows preserved LVEF at 60%, hypertrophy of the posterior wall at 13 mm and of the posteromedial pillar with slightly dysplastic mitral valves without stenosis or regurgitation. A stress test and a rhythmic holter were performed without abnormalities. Tilt-test showed a mixed response with a predominantly cardioinhibitory component. An MRI was requested, questioning the left ventricular hypertrophy and describing an inferior mid-ventricular myocardial cleft variant facing the VD-VG junction. Conclusion: The authors intend from this observation to study the clinical, radiological and evolutionary aspects of myocardial clefts and to emphasize the interest of follow-up in this setting. Submission ID: 1025 INFECTIVE ENDOCARDITIS ON DUCTUSARTERIOSUS: A MYTH OR A REALITY? NOAMEN AYMEN, Tlili Ghassen, Mahfoudhi Houaida, Jabloun Taha Yassine, Hajlaoui Nadhem, Fehri Wafa Military Hospital of Tunis, Tunisia Introduction: The occurrence of infective endocarditis on a patent ductusarteriosus is a rare complication nowadays, but it remains a serious complication to be feared. Case Presentation: We report the case of a 10 year old female child with no medical history who consulted for weight loss. On examination, the patient was hypothermic and pale. Cardiac auscultation revealed a continuous left subclavicular murmur without signs of heart failure. Biological workup showed a Hemoglobin of 6.6 g/dl, White Blood Count of 12060 with a predominance of neutrophils and C-Reactive Protein level was 339 mg/l. An echocardiography (TTE) revealed a large patent ductusarteriosus with exclusive left-right shunt and a flow rate of 4.8 m/s along with vegetations on the trunk of the pulmonary artery in front of the ductusarteriosus and on the isthmus. The patient was put on antibiotic therapy for 40 days with favourable course. The follow-up TTE showed the disappearance of the vegetations. Conclusion: Infective endocarditis on ductusarteriosus is a rare complication, and may be averted by percutaneous closure of the ductusarteriosus.
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