AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • SMC-PAFCIC Abstracts October 2022 60 Submission ID: 1710 COMPLETE HEART BLOCK AND PREGNANCY : A MANAGEMENT DILEMMA DHIMENE SAFAE, BERHIL TAHA, EL BOUSSADANI BADRE, RAISSOUNI ZAINAB MOROCCO Background/Introduction: Congenital atrioventricular block (CAVB) is a rare but not exceptional pathology that is caused by many etiologies; the main CAVB’s etiology is immunological. An atrioventricular block is a distribution of cardiac conduction with abnormal electrical impulse propagation due to a structural or functional abnormality. Symptom analysis should include the evaluation of systemic and chronic signs. 30% of CAVBs remain asymptomatic and are generally incidentally discovered during pregnancy. Case: This report relates to a case of CAVB in a 37 years old pregnant female, mother of one, who presented to the obstetric emergency of Tangier in spontaneous labour at 39 weeks of gestation. Her past medical and family histories were unremarkable, besides the same episode of AVB, during her first childbirth four years ago. The patient did not have preconception counselling. There was no associated syncope, lipothymia or chest pain. The clinical examination did not reveal any particular anomaly; the heart sounded well, no edema, and the peripheral pulses were present and symmetrical. The electrophysiological study showed a 3rd-degree atrioventricular block with a heart rate of 40 bpm. Transthoracic echocardiography did not show any cardiomyopathy or significant valvular disease. After a complete risk and benefit analysis, the approach was decided by a multidisciplinary team involving cardiologists, gynecologists, neonatologists and anesthesiologists; the indication of cesarian delivery was based on a fetoplacental disproportion. During the cesarian delivery, no changes in hemodynamics were observed; a constant HR of 40 bpm under injection of atropine every 5 min. The newborn had a normal Apgar score. The mother underwent ECG monitoring for the following four days in an intensive unit no modification was detected. In order to find the origin of this pathology, a range of autoimmune assessments has been done. Conclusion: This case highlights the severity of asymptomatic AVB; indeed, in the absence of unfavourable risk factors, it is not necessary to propose the installation of a pacemaker; a follow-up is, however, essential. Submission ID: 1714 MYOCARDIAL INFARCTION AFTER COVID-19 VACCINATION: A CAUSAL LINK? KAMAL MARZOUKI, MOHAMED AOUDAD, WAFA EL MIRE, AHMED YOUSSOUF ADDOU, AMALE TAZI MEZALEK, AATIIF BENYASS MOROCCO Background: Vaccination against Vaccine-19 is currently the only effective means of protection against mortality and severe forms of the infection. Minor side effects are quite frequent, serious and severe events related to vaccination remain rare. We report in our observation a case of myocardial infarction (MI) following vaccination with the Sinopharm vaccine. Case presentation: A 48-year-old man, a smoker with no other cardiovascular risk factors, presented with acute coronary syndrome 3 days after the second dose of Sinopharm vaccine. The admission ECG revealed an anterior ST elevation with right bundle branch block and ventricular extrasystoles. Transthoracic echography showed left ventricular inferior and inferoseptal wall akinesia, with an impaired ejection fraction of 45%. Coronary angiography demonstrated triple stenosis of the Left Anterior Desending (LAD) Artery, including a critical proximal lesion, with an occluded Right Coronary Artery (RCA) of chronic appearance. The proximal LAD was successfully dilated with active stent angioplasty, and the outcome was favorable. Discussion: Rarecasesof post-vaccinationMI havebeen reported in the literature, without establishing a direct cause-and-effect relationship. Several theories are possible: stress in a context of mistrust of the vaccine’s side effects, inflammatory and sometimes allergic reaction, may be the cause of atherothrombotic complications of a pre-existing coronary artery disease. In the absence of evidence and in view of the rarity of cases, simple coincidence may also be considered. Conclusion: Acute coronary syndromes, reported after vaccination against covid-19, remain rare. Particular attention should be paid to identifying these events as well as proposing preventive measures, especially among coronary patients who are candidates for vaccination. Submission ID: 1717 PROGNOSTIC FACTORS OF MORTALITY DURING INFECTIOUS ENDOCARDITIS IN THE UNIVERSITY HOSPITAL OF MARRAKECH H NABAWI, M BOUTGOURINE, M EL JAMILI, S EL KARIMI, M EL HATTAOUI MOROCCO Background: Infective endocarditis (IE) is an infection of the endocardium caused by bacteria, fungi, or germs that enter through the bloodstream. Despite great medical progress, IE remains a serious and lethal infection with a high frequency and a poor prognosis. Objective: Our aim is to determine the predictive factors of overall mortality during IE. Methods: Retrospective and descriptive study conducted in the cardiology department of the University Hospital of Marrakech January 2017 to July 2022. including 99 patients hospitalized for IE. Its diagnosis is according to the modified DUKE criteria. MODERATED POSTER SESSION
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