AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 40 Submission ID: 1000 PROGNOSTIC FACTORS OF MYOCARDIAL INFARCTION AMONG YOUNG ADULTS Allouche Emna, Anis Ghariani, Neji Syrine, Fathi M., Boudiche F., Ben Jemaa H., Beji M., Ouechtati W, Ben Abdessalemn Mohamed Aymen, Ben Ahmed Habib, Bezdah Leila UHC Charles Nicolle, Tunisia. UHC Farhat Hached, Tunisia Background: Prognostic factors of myocardial infarction among the young adults are still not well identified. The aim of our study was to determine the predictive factors of in-hospital major adverse cardiac events following myocardial infarction in the young. Methods: From January 2014 to May 2017, we retrospectively studied data of patients with acute myocardial infarction younger than 45 years old in the department of cardiology of Charles Nicolle hospital of Tunis. Results: We enrolled 108 patients in the study. The prevalence of acute myocardial infarction in young patients was 8.5%. The mean age was 39.5 ± 5.5 years with a sex-ratio of 11. The most frequent cardiovascular risk factors were smoking (88%) and dyslipidaemia Submission ID: 1001 JUNCTIONAL TACHYCARDIA IN CHILDREN: IS IT A WPW SYNDROME? GHARDALLOU HOUDA, HAKIM KAOUTHAR, OUAGHLANI KHALIL, BEN OTHMEN RIHAB, KARMOUS RAHMA, EL BARDI MOUADH, BEN DOUDOU MAROUA, FTINI SIRINE, ASSOUFI F ZAHRA, MSAAD HELA, OUARDA FATMA PEDIATRIC CARDIOLOGY DEPARTMENT LA RABTA HOSPITAL TUNIS, TUNISIA Introduction: Wolf Parkinson White Syndrome (WPW) is defined as the presence of an accessory pathway that shortcuts electrical conduction between the atria and the ventricles. The diagnosis is suspected on the ECG and confirmed by electrophysiological study (EPS). Finding a ventricular pre-excitation on ECG consistent with a WPW pattern is quite common in pediatric population. However, clinical tachycardias are less often and the age of the patients remain the main limiting factor to EPS study in order to confirm the diagnosis and indicate radiofrequency ablation. Aim of the study: The aim of this study was to assess the incidence of accessory pathways in pediatric population and to describe its clinical and electrophysiological profile. Methods: We carried out a descriptive study reporting all cases of junctional tachycardia (TJ) collected at the pediatric cardiology department of La Rabta hospital between January 2019 and March 2021. Results: Fifteen patients were included in this study (mean age= 6.56years [4days-14years] Sex Ration=1,14). A typical ECG pattern was identified in 11 patients (73% of the population). The tachycardia was symptomatic in all of these patients. Hemodynamic compromise was observed in 5 patients. EPS was performed in only 5 patients aged over 5 years. This showed that the accessory pathway was left and posterolateral in 2 patients, right lateral in 1 patient, left posterior in 1 patient and antero-septal in one patient. The mean shortest pre-excited RR interval (SPERRI) was 288 ms. Successful ablation was achieved in all of these patients. Recurrence of clinical tachycardia was observed in 2 patients with normal structural hearts and in one patient with Ebstein’s disease. Conclusion: Accessory pathways account for more than 80% of junctional tachycardias in children. EPS remains limited by the young age of patients because the procedure is technically impractical before the age of 5-6 years and for a weight less than 15Kg. Vascular access is another limiting factor in such a young population. The prognosis is generally good and the invasive exploration should be carefully considered. MODERATED POSTER SESSION 3 Submission ID: 987 OUTCOMES OF CHILDHOOD HYPERTROPHIC CARDIOMYOPATHY Ben Othman Rihab, Hakim Kaouthar, Msaad Hela, Oueghlani Khalil, Ghardallou Houda, Karmous Rahma, El Bardi Mouad, Ouarda Fatma Pediatric cardiology department of the Rabta Hospital, Tunisia Background: Outcomes of children with hypertrophic cardiomyopathy (HCM) have not been will defined. We examined late survival and symptomatic status for pediatric HCM. Methods and results: From January 1999 to July 2020, 57patients were hospitalized in the pediatric cardiology department of the Rabta hospital at a median age of 1,4 years (range 0-18 years). Aetiology was: idiopathic HCM (n=34, 60%), inborn errors of metabolism (IEM) (n=14, 25%), RASopathy (n=8, 14%) or Friedreich’s ataxia (n=1, 2%). Mean length of follow-up was 7,1 ± 6,1 years. Seven patients (12%) were classified as lost to follow-up. Four patients (8%) underwent Implantable cardioverter defibrillator (ICD) for primary (n=3) or secondary (n=1) prevention. At last clinical follow-up, 59% of survived patients were asymptomatic and 12% presented signs of heart failure. Three patients (6%) survived a major arrhythmic event (sustained ventricular arrythmia in one patient and appropriate ICD discharge in two patients) during follow-up. Sixteen patients (32%) died at an age ranging from two days of life to 32 years old with a mean value of 10,7±10,4 years old. The causes of death were: sudden cardiac death (SCD) in nine patients, congestive cardiac failure in six patients and after cardiac surgery in a patient. Our study did not reveal a significant difference in mortality between the different etiologies. Congestive cardiac failure was more common in infants. Eighty-nine percent of patients who died suddenly were aged under 18 years at the time of death. Conclusions: This study is the largest study in our country including children diagnosed with HCM. The results show that pediatric HCM is a heterogenous disease in terms of aetiology and outcomes. Sudden cardiac death is the most common cause of mortality. More studies are needed in order to better stratify this risk in pediatric HCM. (51.9%). In-hospital complications occurred in 47.2% of cases. Factors associated with in-hospital major adverse cardiac events were: age over 41 (p=0.02), a heart rate over 82 (p=0.007) and the association of at least three cardiovascular risk factors (p=0.031). The age over 41 was identified as an independent predictive factor of in-hospital major adverse cardiac events (odds ratio = 3.454, CI 95% [1.329 – 8.974], p= 0.011). Conclusion: Despite its favorable outcome, the acute myocardial infarction in the young is still a serious health problem. Primary preventive measures aimed at preventing our youth from adopting tobacco use and developing dyslipidemia should be implemented to delay and even avoid the onset of coronary artery disease.
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