CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 43 AFRICA Submission ID: 1068 KOUNIS SYNDROME: ALLERGIC ACUTE CORONARY SYNDROME dardouri safa, gribaa rim, ouanes sami, Imen Ben Ali, slim mahdi, el hraiech aymen, ben farhat sameh, naffeti ilyes Tunisia Background: Kounis syndrome (SK) is defined as an acute coronary syndrome occurring in a allergy context. It was first described by Kouniset Zavrasen in 1991. The ischemia in allergic reaction is secondary to the release of inflammatory mediators, including histamine, tryptase, chymase, platelet-activating factor, cytokines, and prostaglandins, and leukotriene synthesis, which leads to coronary vasospasm. Aim: to know how to suspect and question the patient well, so as not to miss this syndrome. Case report: We report the case of a 45-years-old man, smoker, who consults the emergency room for chest pain with generalized urticaria, all following a bee sting. The admission examination revealed a heart rate of 80 beats per minute and blood pressure of 80/40 with absence of peripheral signs of shock. His electrocardiogram showed the presence of an ST segment depression in apicolateral and inferior. The patient was putted on a low dose of 0.5mg / hour norepinephrine and received 200mg of hydrocortisone hemisuccinate. The evolution was marked by a good clinical evolution and a regression in the hour of repolarization disorders. A complement by a computerized tomography (CT) coronary angiogram, looking for an underlying coronary stenosis, was done, returning without abnormalities. Conclusion: Type I kounis syndrome, as is the case with our patient, includes patients with healthy coronary arteries, without factors predisposing to coronary artery disease in whom allergic stimulation leads to coronary spasm with normal cardiac biomarkers or infarction with positive biomarkers. This variant represents a manifestation of endothelial dysfunction or microvascular angina. Diagnosis and treatment of KS can be difficult, requiring simultaneous attention to cardiac and anaphylactic pathophysiology. MODERATED POSTER SESSION 3 Submission ID: 1080 PREDICTIVE VALUE OF THE CHA2DS2-VASC SCORE FOR SEVERITY OF CORONARY ARTERY DISEASE IN PATIENTS WITH ACUTE CORONARY SYNDROME BOUSSEMA AMINE, BEN HALIMA MANEL, REKIK BASSEM, BOUDICHE SELIM, OUALI SANA, FARHATI ABDELJELIL, MGHAIETH FATHIA, MOURALI MOHAMED SAMI CARDIOLOGY DEPARTMENT OF LA RABTA, Tunisia Background Prevalence of heart failure patients (HF) is increasing worldwide due to the aging of the population and improvement in managing coronary artery disease and hypertension, which remain the main etiologies. The prognosis of this pathology remains bad especially in acute heart failure with represents its worse feature. Objectives and method A monocentric prospective study enrolling consenting patients over 18 years old admitted presenting with acute heart failure from January 2018 to September 2019 is performed in order to determine their prognosis and epidemiologic profile with a follow up of 6 moths. The primary endpoint is all causes death. Results 221 patients are enrolled. Mean age is 63 years old. Sex ratio is 1.63. Hypertension (59%) is the main cardiovascular risk factor, 45% are diabetics and 16% unveiled active smokers. Ischemic etiology (34%) is the most common followed by hypertensive heart disease (19.5%), cardiomyopathies (13%), and valvular heart disease (12%). Acute coronary syndromes (18.6%) and infections (18.1) are the main precipitating factors. “De novo” type is more common (68%) than chronic decompensated HF (33%) and the global forms are predominant (53.4%). The 6 months mortality is 41 % using the Kaplan Meier method. Prognostic factors were a high level of NTProBNP and liver transaminases and dilation of inferior vena cava. Conclusion Despite all the efforts made to improve the outcome of HF syndroms, AHF remains a challenge. New therapeutics in this field have shown a lowering in the incidence of death and rehospitalitions . A better knowledge of HF should bring other answers to many issues met in our daily practice. Submission ID: 1089 RECURRENT ST-SEGMENT ELEVATION AFTER SUCCESSFUL PERCUTANEOUS CORONARY INTERVENTION Aiman GHRAB, Zine Elabidine Ben Ali, Ali Khorcheni, Chaima Ghorbel, DALI ALA EDDINE, WAJIH ABDALLAH, SAMI MILOUCHI HABIB BOURGUIBA UNIVERSITY HOSPITAL OF MEDENINE, TUNISIA We report a case of a 32-year-old male who experienced an STSegment elevation myocardial infarction in the inferior territory. Percutaneous coronary intervention was successful in restoring a TIMI 3 flow in the right coronary artery. The angiogram also showed a chronic total occlusion of the marginal artery. The patient had multiple cardiovascular risk factors: new onset diabetes, smoking and obesity. He received double antiplatelet therapy, ACE inhibitor, betablockers and statin with good in-hospital evolution. Four months later, the patient presented to the emergency department with chest pain. The ECG showed ST-segment elevation in the anterior territory.
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