Twenty-third PanAfrican Course on Interventional Cardiology SMC-PAFCIC 2022

AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • SMC-PAFCIC Abstracts October 2022 58 Submission ID: 1697 INTRACARDIAC THROMBOSIS AND VASCULAR INVOLVEMENT IN BEHÇET’S DISEASE: TWO SIDES OF THE SAME COIN? SARRA CHADLI, HAJAR KHIBRI, SAFAA FARI, NAIMA MOUATASSIM, WAFAA AMMOURI, MOUNA MAAMAR, MOHAMED ADNAOUI, ZOUBIDA TAZI MEZALEK MOROCCO Background: Behçet’s disease (BD) is a relapsing vasculitis that can affect vessels of all sizes and kinds. Intracardiac thrombosis (ICT) is a serious complication of BD, that often presents associated with vascular lesions. Objectives: Our study aims to describe the clinical profile, imaging features, therapeutic management, and outcomes of BD patients with ICT. And secondly, to shed some light on the relation between ICT and the vascular involvement of the disease. Methods: We retrospectively conducted a descriptive study including 446 Behçet patients admitted to our department between 2010 and 2022. Results: Twelve patients with ICT related to BD were enrolled. The sex ratio (M/F) was 9 and the mean age was 29 ± 6 years (20-41). ICT occurred as the revealing form of BD (50%), or after a median of 4 years [1; 8] since the disease onset (50%). Symptoms were : dyspnea (50%) chest pain (50%), dry cough (40%), and hemoptysis (30%).Concurrent BD flares were mainly mucocutaneous (80%). Inflammatory parameters were elevated with a median ESR of 48 mm/h and CRP of 52 mg/L. On echocardiography, ICT was located in the right cavities (100%), with an extension to the inferior vena cava in half of the cases. Multiple thrombi were visualized (33%). Associated cardiac lesions were: pericardial effusion (50%), tricuspid (50%) and mitral insufficiency (10%), endomyocardial fibrosis (10%), myocarditis (10%), and ischemic coronaropathy (8%). Pulmonary hypertension (75%) and right dilatation (58%) were common. On chest angioCT, pulmonary artery involvement was frequent (80%): thrombi (70%) and aneurysms (50%). Other sites of venous thrombosis included: superior vena cava (n=2), lower extremity (n=5), suprahepatic (n=2), internal jugular (n=1), pulmonary (n=1), cerebral (n=1) and superior mesenteric (n=1) veins. All patients were treated with colchicine, glucocorticoids, and immunosuppressants: cyclophosphamide (n=11), methotrexate with a TNF-alpha inhibitor (n=1). Six patients were under curative anticoagulation. The outcomes were classified as complete (n=7) or partial remission (n=3), and relapse (n=1). No death was recorded. Conclusion: ICT usually occurs in the first years of BD’s onset, among young men with vascular lesions, especially of the pulmonary arteries and vena cava. We believe that this strong association is highly suggestive that, unlike common thrombotic diseases, ICT in BD is a direct consequence of the underlying vasculitis. Pulmonary artery thrombosis and aneurysm in a BD patient with ICT. TTE of a floating right intraventricular thrombus in a BD patient. Submission ID: 1698 RUNAWAY PACEMAKER PHENOMENON: WHEN A PATIENT ALMOST PASSED AWAY DAHIMENE NAWEL, SIK AREZKI, BAOUNI MOHAMED MEHDI, LOUALI INSSAF, BOURAHLA LAMIA, AIT MOKHTAR OMAR, BENKHEDDA SALIM ALGERIA Background: Pacemaker implantation is a salvatory procedure in most situations. However, it still carries some risks as any device dysfunction can have dark consequences for the patient. Despite the technological progress in cardiology, runaway pacemaker phenomenon is still described and can cause critical bradycardia, arrythmia and even death. The clinical context of this phenomenon is a pacemaker’s battery depletion almost all the time and this is why a rigorous patient’s follow-up is important. In this clinical case, we are going to describe a 96 years old man, who had a pacemaker implantation in 2007. He missed his last device follow-up because of the covid 19 pandemia and came to our emergency department for syncope. The 12 lead EKG showed a typical runaway pattern. Even if this is relatively an infrequent situation every cardiologist has to recognize the EKG pattern, know the different clinical situations possible and how to manage each of them. MODERATED POSTER SESSION

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