AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 46 Submission ID: 1130 MORTALITY PREDIVTIVE FACTORS IN YOUNG PATIENTS WITH HEART FAILURE (HF) MARIEM DRISSA, ASMA BRAHIM, OUMAYMA TAHER, REFKA OUESLATI, ASMA BOUSLIMI LA RABTA, TUNISIA Introduction: HF is an enormous clinical burden in adult medecine, it remains frequent even among young adults (<40 years old) causing deterioration of quality of life. Aim: Is to study predictive factors of mortality in HF among young population. Methods: Our study is prospective and descriptive. We have tracked 40 patients and followed them up over 1 year from september 2020 to september 2021, who were hospitalized in ‘Adults’ cardiology Department in Rabta hospital for management of acute HF. All echocardiographic exam were carried by transthoracic way (TTE). The majority 82.5% were explored by coronary angiography. Results: The mean age was 33 +/- 6. 65% men and 35% women. Patients were active smokers in 35%(14), 22,5% (9) had hypertension, 20% (8) diabetes mellitus, 12,5% (5) Chronic kidney disease . Obesity (BMI>= 30) and history of coronary artery disease CAD were both found in 5%(2) of cases. The mean left ventricular ejection fraction LVEF was 34.6+/-9. The principal cause of heart failure in our population was valvular herat disease in 25% followed by CAD 17.5%. The tracking at one year showed 28 survivors, 4 people lost of sight and 8 deaths. The predictive factors of mortality found in our study were obesity p=0.038 and male gender p=0.037, the Clinical signs were right HF p=0.004 concording with right ventricular dysfunction p=0.044 in TTE and LVEF <30% p=0.038. Conclusion: While an uncommon diagnosis, young adults can present with HF secondary to a variety of etiologies. A high index of suspicion should be maintained when young patients present with active smokig, obesity , male gender and clinical or echocardiographic signs of right HF. MODERATED POSTER SESSION 3 Submission ID: 1150 PERIPARTUM CARDIOMYOPATHY: A DISEASE WITH A MYSTERIOUS COURSE Mariem Drissa, Cyrine Aouji, Essia Chahnez Mousli, Habiba Drissa Tunisia Introduction Peripartum cardiomyopathy (PPCM) is rare. The subsequent course of the disorder remains unclear. The purpose of this study was to identify the predictive factors of left ventricular (LV) recovery in patients with PPCM. Methods We retrospectively reviewed the records of 35 patients hospitalized for the diagnosis of PPCM in our department between 2009-2019. All patients were followed clinically and by means of echocardiography after 6 months and over one year later. Results the mean age was 33 ± 2years (22-44); 28 patients were multiparous, 17 women had multifetal pregnancies, 18 patients had presented severe preeclampsia. PPCM was diagnosed in the majority of cases in antepartum. Clinically, pulmonary oedema occurred in only 18 Submission ID: 1162 MEDICO-LEGAL ASPECTS OF SUDDEN CARDIAC DEATH AT WORK: A RETROSPECTIVE STUDY DURING 28 YEARS Dorra Oualha, Wissem Bedoui, Meriem Grayaa, Nidhal Haj Salem, Tunisia Background Sudden death can occur in the workplace, favored by physical effort, stress, or other job factors (noise, heat, …). To attribute these deaths to work conditions requires medico-legal investigations. The aim of this study was to analyze the socio-professional characteristics of sudden cardiac death victims in the workplace and to discuss the medico-legal consequences. Methods It was a retrospective descriptive study including all cases of sudden deaths occurring in the workplace, conducted in the Department of Forensic Medicine at Fattouma Bourguiba University Hospital of Monastir over a period of 28 years. Results We identified 261 cases who died at work. Trauma was the main cause of death (71.9%) followed by electric shock (22.5%) and sudden death (17.2%, 46 cases). At forensic autopsy, myocardial infarction secondary to coronary artery disease was the most frequent lesion (33%). Fifty percent of the remaining cases showed atheromatous coronary arteries without macroscopic lesions of the myocardium. All victims were males aged over 40 years. Diabetes and hypertension were the most frequent pathologies in these victims. Coronary artery disease was the main cause of death in guards (26.3%), with a peak in frequency on Mondays (6 cases). One case of severe aortic stenosis and one case of hemorrhagic stroke have been reported. Conclusion The majority of sudden death at work were due to cardiac causes. They were dominated by coronary disease and acute heart failure. Work-related stress is a risk factor for the development of cardiovascular complications. In these cases, medico-legal investigations including an autopsy with histological and toxicological samples to determine the cause of death are needed. Also, investigations of the accident circumstances and the professional factors (stress, effort, climate, noise...) are necessary to establish the causality. patients. Echocardiographic findings at admission revealed a dilatation of the left ventricle (LV) for all patients, with a mean ejection fraction (EF) of 26 % ±15. All patients received intravenous diuretics in case of acute heart failure. Converting enzyme inhibitors, beta blockers and mineralocorticoid were prescribed for respectively 18 and 15 patients. The minimum duration of treatment was about 6 months for 15 patients and over a year for the rest of the patients. Inotropic drug, and circulatory support: were necessary in 5 cases. Intrahospital mortality rate was 1 % and it was mainly due to cardiogenic shock. 12 patients (45%) had improved their LV ejection fraction (LVEF) within 6 months. After 24 months, 13 had totally recovered their LVEF and 5 patients had just a mild improvement of their LVEF. In multivariate analysis, we found that some factors were associated with a higher likelihood of recovery, specifically, the postpartum diagnosis of PCCM, an LVEF >30%, and a LV end diastolic diameter (LVEDD) <6 cm. Conclusion PCCM is an uncommon complication of pregnancy with an unknown etiology. Pre-eclampsia and multiparity seems to be strongly associated with PCCM. A part from diagnosing this disease, echocardiography can provide some valuable informations to predict the recovery prognosis while following the course of the disease which is still a mystery.
RkJQdWJsaXNoZXIy NDIzNzc=