CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 47 AFRICA MODERATED POSTER SESSION 3 Submission ID: 1165 PREDICTIVE FACTORS OF CORONARY LESIONS IN POSITIVE EXERCICE TESTING DRISSA MARIEM, OUMAIMA TAHAR, REFKA OUESLATI, ASMA BRAHIM, ASMA BOUSLIMI LA RABTA HOSPITAL, TUNISIA Introduction: Coronary artery disease CAD is still frequent in our country, it has poor prognosis, altering the quality of life and has heavy socioeconomic repercussions. Early diagnosis is therefore crucial for ensuring the best quality of care using non invasive ischemia tests such as exercice ECG, an available and affordable exam. Purpose: Is to study the correlation between positive EE and significant lesions in coronary angiography CA. Methods: Our study is retrospective, descriptive including 51 patients hospitalised for chronic coronary syndrome in the « Adults » cardiology department of the Rabta hospital between Jnavier 2021 and octobre 2021. Our patients had EE and coronary angiography CA. Results: Mean age was 58+/-9 years old. 28(55%) men and 23(45%) women, 36(71%) patients had hypertension, 27 (53%) had diabetes mellitus, 8(15.7%) patients with history of CAD, 4(7.8%) patients with severe chronic kidney disease, 15 (29.5%) were active smokers. Left ventricular dysfunction was present in 8 patients (15.7%) and significant lesions in CA in 30 patients (58.1%). Main correlation between positive EE and the presence of severe lesions in CA were found in active smokers patients p=0.003, male gender p=0.04, history of coronary artery disease p=0.014, men with CKD p=0.04. Nevertheless, young female patients (<45 years old) were more likely to have insignificant lesions in coronary angiography despite of positive EE. Conclusion: EE is useful to predict coronary lesions among patients suffering from CCS. In agreement with previous studies, active smokers, male gender with CKD and patients with history of CAD are more likely to have lesions in coronary angiography. Submission ID: 1167 NEURO ENDOCRINE CARCINOMA REVEALED BY A TAMPONADE: A CASE REPORT Zied Ibn El Hadj, Achref Hamdani, Zaineb Ajra, Ahlem Khannouch, Mouna Hachani, Salma Kraiem, Nesrine Beya, Refaat Gheni, Lamia Rashiqou, Riadh Ben Hmida, Taha Ounissi Cardiology department, Mohamed Taher Maamouri university hospital, Nabeul, Tunisia A case report A 48-year-old man was admitted to our hospital, with complains of prolonged retrosternal tingling-type chest pain without irradiation aggravated on deep inspiration and relieved by the lean forward position associated with dyspnea, dysphagia to liquids then to solids, weight loss and asthenia since 2 months occurring gradually. Physical examination showed a tachycardia at 106 bpm, polypnea, muffled heart sounds and turgor of jugular veins. The patient’s ECG showed diffuse microvoltage. Chest x-ray film showed cardiomegaly, para-hilar and para-cardiac opacities. Laboratory data nonwere revealingC-reactive protein 7,23mg/dl, WBC count are normal. An emergency echocardiogram showing a very abundant heterogeneous circumferential pericardial effusion. A puncture drainage was made urgently bringing back 250ml, The fluid was bloody and contained 45 g/l of protein. Cytopathological study of fluid showed tumor cytology. A thoraco-abdomino-pelvic CT scan showing an anterior mediastinal mass primarily suggesting infiltrating thymoma with pericardial and pleural effusions of carcnomatous origin. One week after the puncture, a control echocardiogram done showing recurrence of large circumferential effusion, variation in mitral flow 23%, dilated and compliant IVC, paradoxical septum. He was presented to the thoracic surgery staff but his file was not accepted since the mass is inoperable and even the pleuro-pericardial window was impossible. So a scanno-guided biopsy was made for the etiological confirmation and a radiochemotherapy is planned afterwards. Conclusion Although infrequent, neuro endocrine carcinoma may present solely as tamponade. Thymomas often require emergency treatment due to their association with complications such as cardiac tamponade and cardiac failure. The late discovery makes the prognosis worse.
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