CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 31 AFRICA Submission ID: 1091 IMPACT OF CENTRAL VENOUS PRESSURE ON MORTALITY IN PATIENTS ADMITTED FOR SHOCK Maatouk Iyed, Oussama Jaoued, Nizar Mechri, Habiba Ben Sik Ali, Mohamed Fekih Hassen, Souheil Elatrous Medical Intensive Care Unit of the University Hospital Tahar Sfar Mahdia, Tunisia Background: Central venous pressure (CVP) between 8 and 12 mmHg was one of the objectives in the management of patients in septic shock. The impact of high CVP on mortality in cardiogenic shock could be pejorative due to visceral congestion. Furthermore, the threshold value of PVC remains controversial. We aimed to determine the impact of CVS >10.5 mmHg on the mortality of patients admitted for shock (EDC). Methods: This is a retrospective study conducted in the intensive care unit of the university hospital Taher Sfar of Mahdia (Tunisia) between February 2017 and October 2018 including all patients admitted for shock with a CVS measurement on admission. Two groups were individualized: Group (G1): High CVP > 10.5 and Group (G2): Low CVP ≤ 10.5. The CVP threshold was chosen based on the literature data. The collected parameters were: demographic characteristics, co-morbidities, SAPSII gravity score, shock mechanism, PVC on admission, use of mechanical ventilation (MV), length of stay, and mortality. Results: During the study period, 62 patients (mean age 63±15 years, and MODERATED POSTER SESSION 2 Aim: Early detection of myocardial involvement, before left ventricular ejection fraction deterioration, based on iterative measurement of biomarkers. Materiels and Methods: This is a descriptive study carried out at the cardiology department of Farhat Hached university hospital in Sousse, and this during the period between January and August 2019. One handred patients treated by cardiotoxic CT for any type of cancer combined.dosage of troponin and NT pro BNP before and three weeks after the first course of chemotherapy was performed. Results and Discussion: The mean age of the study population was 45.9 ± 7.9 years. The level of troponin was zero in all our patients before their first treatment of CT. We set the BNP positivity threshold at 100 pg / ml.We noted a significant elevation of troponins in 9 patients distributed as follows: Two patients presented with ECG changes associated with chest pain. Coronary angiography was postponed due to severe anemia. One patient developed moderate abundance of pericardial effusion. diagnosis of pulmonary embolismwas confirmed in another one. Three patients were diagnosed with acute renal failure or sepsis. We noted an increase in BNP in 6 patients: Two patients (33.3%), one related to a degradation of LVEF to 38% and the second with a decrease in LVEF but less than 10%.One patient (16.6%) who presented with palpitations with several supraventricular extrasystoles on the ECG. In 3 patients (50%) work-up was requested which included a determination of renal function, an infectious work-up and a review of the extensive of the underlying neoplasia. Conclusion: Dosage of troponin andBNP cannot replace LVEFmeasurements,but it is a diagnostic and prognostic element that takes its place in the overall follow-up of cancer patients. mean SAPSII of 54±16) were included. Cardiogenic shock was the most common mechanism of shock (55%). MV was initiated on admission in 89% of patients. The mean CVP at admission was 10 + 5 mmHg. Overall mortality was 47%. Thirty-four patients had CVP ≤10.5 on admission. A CVP≤ 10.5 was observed more frequently in patients admitted for septic shock while a CVP >10.5 was more frequent in patients admitted for cardiogenic shock. There was no significant difference between the two groups of patients with or without CVS <10.5 in severity scores, duration of VM and length of stay. Mortality was 53% in group G1 versus 39% in group G2 with p=0.28. Cardiac output was similar between the two groups. In multivariate analysis, no factor was associated with mortality. Conclusion: Excess mortality was observed in patients in shock with CVP > 10.5. This result can be explained by the predominance of cardiogenic shock. Submission ID: 1105 FATAL ACUTE AORTIC SYNDROM Jaweher kamoun,Asma Azouz,Said Saadi,Sami Ben Jomaa, FatmaNasraouui, Nidhal Haj Salem Department of forensic medicine of Monastir, Tunisia Introduction: Sudden death secondary to cardiovascular cause is common. Acute aortic syndrome (AAS) represents one of the most dramatic cardiovascular emergencies, often fatal in the absence of adequate and prompt management. It is often secondary to inherited connective tissue disorders, trauma or high blood pressure. The aim of our work was to report epidemiological peculiarities of fatal AAS and its medico-legal characteristics in order to deduce the necessary preventive healthcare measures. Methods: A descriptive and retrospective study including forensic autopsies that where performed for corpses after fatal AAS, in Department of forensic medicine of Monastir, during a period of 28 years (between 1993 and 2021). We included all fatal AAS cases grouping pathologies of thoracic and / or abdominal aorta that lead to death. These latter included: traumatic and non-traumatic aortic dissections (AD) as well as dissecting aortic aneurysms. Results: We collected 41 cases of fatal AAS including 32 cases of AD (6 of which were post traumatic) and 9 cases of dissecting aortic aneurysm. We found a male predominance with a sex ratio of 19.5 (39 men and 2 women). The mean victims’ age was 54.93 years (16 - 76 years). A family-history of sudden cardiovascular death was found in only two cases (4.9%). Twelve victims (29.3%) had a personal history of high blood pressure, 11 were active smokers, 8 were chronic alcohol drinkers, and 4 were diabetic. We did not report genetic or inflammatory diseases. Death was preceded by prodromal signs in 56.1% of cases. These signs were mainly chest pain (12 cases) and discomfort(11 cases). Eight deaths were observed during physical activity (4 occurred during daily exertion, 2 occurred during labor and 2 were linked to sports activity). At autopsy, we noted type AAD, the presence of a hemopericardium and hemothorax in respectively 68.3, 61, and 22% of cases. Complete aortic rupture was noticed in 47.5% of cases. Conclusion: Fatal AAS is an uncommon pathology, especially in young adults. His spontaneous prognosis is appalling. Optimizing its management withrisk factors control is necessary to prevent the risk of sudden cardiovascular death.
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