AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 44 By the time the patient arrived at our Cath lab, he was pain free and the ECG showed no repolarisation abnormality. Coronary angiogram was normal and did not show any sign of stent thrombosis. The analysis of the ECG monitoring during hospitalisation showed transient ST segment elevation often followed with malignant ventricular arrythmias concomitant to chest pain episode especially in early morning. The vasospastic origin was highly suspected. We decided to optimize the treatment: stop betablockers, add calcium channel blockers and abolish smoking for good. Three weeks later, the patient reconsulted the emergency department with chest pain. ECG showed no abnormalities, but troponin came back positive. The patient was hospitalized in our coronary care unit. During the first 24-hours, the patient had another episode of chest pain with ST segment elevation in the inferior territory. We decided to do an urgent coronary angiogram using the femoral artery to avoid using nitrates. It showed a TIMI 0 flow in the right coronary artery. The injection of intracoronary nitrates restored a TIMI 3 flow and normal coronary angiogram. This case highlights the possible association of coronary vasospasm and atherosclerosis and the morbid interaction between the two entities. Keyword: coronary vasospasm, myocardial infarction, young adult, case report. Submission ID: 1094 QUALITY OF LIFE AMONG PARENTS OF CHILDREN WITH CONGENITAL HEART DISEASES Houda Ajmi, Nada Boukadida, Fadoua Majdoub, Salsabil Nouir, Sameh Mabrouk, Noura Zouari, Jalel Chemli, Saoussen Abroug Pediatric department of Sahloul Teaching Hospital, Tunisia Introduction: Congenital heart diseases (CHD) interfere with family life and can cause serious difficulties. Aim: The study examined parent health-related quality of life (HRQOL) among parents of 79 children with CHD and who were referred to the Pediatric department of SAHLOUL Teaching Hospital over 2 years (2019-2020). Methods: Parents’ quality of life was evaluated with the «Medical Outcome Study Short Form 36» (MOS SF-36) in the Tunisian Arabic dialect version. We compared HRQOL among parents of children with severe CHD and parents of children with mild/moderate CHD (we used the ESC 2020 recommendations of classification of CHD complexity). Results: Out of 79 parents, 60 (75.9%) were women (sex ratio of 0.31) and 14 had children with severe CHD. Their average age was 36.63± 7.44 years. The three areas of the MOS SF-36 that were most affected were: vitality (51.25±26.30), general health (58.48±16.77) and mental health (59.49±26.09). The average physical score (PSC) and mental score (MSC) were 77.83 ±16.26 and 64.96 ±24.69 respectively. Parents of children with severe CHD had lower MSC as well as PSC than others but there was no statistically significant difference between the 2 groups in both MSC (p=0.128) and PSC (p=0.585). Conclusion: Our study showed that having a child with CHD may have a negative impact on the parents’ HRQOL. However, there was no statistically significant difference between parents of severe CHD and those of mild/ moderate CHD. MODERATED POSTER SESSION 3 Submission ID: 1109 PERSISTENT ST-SEGMENT ELEVATION DUE TO CARDIAC METASTASIS Sabrine Bousnina, Saoussen Antit, Marwa Abdelhedi, Souha Abid, Emna Rekik, Ridha Fekih, Oussema Wachem, Elhem Boussabah, Lilia Zakhama Interior Security Forces Hospital, Tunisia Introduction: Cardiac metastasis of oral carcinomas is rare; only few cases have been reported in the literature. Clinical findings in those with cardiac metastasis are non-specific. ECG features, if present, are also non-specific. and include ST elevation, atrial fibrillation, right bundle branch block and pathological Q-waves. Persistent ST segment elevation in the absence of Q waves seems to be a pathognomonic sign for tumor invasion of the heart Case Presentation: A 41-year-old woman had undergone surgery for left mandibular cancer followed by chemoradiotherapy. She presented to the emergency room for acute dyspnea. Physical examination found signs of right-sided heart failure. The blood pressure was 90/60 mmHg with a heart rate of 130 bpm. The electrocardiogram showed sinus tachycardia at 130 cpm associated to an incomplete right bundle branch block with diffuse ST-segment elevation. Troponin was elevated with a steady rate. Transthoracic echocardiography showed biventricular infiltration at the mid and apical segments with a large thrombus in the right ventricle partially enclosing the tricuspid valve. Coronary angiography demonstrated normal arteries. A computed tomography angiogram confirmed the bi ventricular tumor infiltration and demonstrated proximal pulmonary embolism. Lung, liver and bone metastases have also been noted. The patient received curative heparin therapy and was managed palliatively. She died approximately 1 month later. Conclusion: Cardiac metastasis of oral carcinomas is rare; only few cases have been reported in the literature. Clinical findings in those with cardiac metastasis are non-specific. ECG features, if present, are also non-specific.. Cardiac ultrasound is the key examination for screening and follow-up. Once diagnosed, treatment is palliative, with radiotherapy and/or chemotherapy.
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