AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • SMC-PAFCIC Abstracts October 2022 64 Submission ID: 1736 CARDIAC AMYLOIDOSIS : A RACE AGAINST TIME SARRA CHADLI, ZINEB FASSI FEHRI, SAMI BELKHETTAB, NAIMA MOUATASSIM, HAJAR KHIBRI, WAFAA AMMOURI, MOUNA MAAMAR, HICHAM HARMOUCHE, MOHAMMED ADNAOUI, AIDA SOUFIANI, ZOUBIDA TAZI MEZALEK MOROCCO Background: Amyloidosis is characterized by the extracellular deposition of misfolded proteins in various tissues and organs. Cardiac involvement is common and has a grim prognosis. Objective: Our study aims to describe the profile, diagnostic workup, therapeutic management, and outcome of patients with cardiac amyloidosis (CA). Methods: We carried out a retrospective, monocentric and descriptive study between 2015 and 2022, including all patients admitted to our department with documented systemic amyloidosis and confirmed cardiac involvement. Results: 31 patients were enrolled. The sex ratio (M/F) was 0.93 and the mean age was 62 ± 15 years (26–86). Past history included: Associated systemic involvements in patients with CA. Etiological investigations of patients with AL CA. multiple myeloma (n=7), monoclonal gammapathy of undetermined significance (n=1), T lymphoma (n=1), and treated systemic amyloidosis (n=1). Patients presented after a mean of 12 ± 4 months since the onset, with peripheral edema (58%) and other signs of right (45%) and global heart failure (16%). Concomitant involvements were mostly renal (35%), neurological (16%), and mucocutaneous (12%). Electrocardiogram showed low-voltage (n=5), atrial fibrillation (n=3), atrioventricular (n=2) and right bundle block (n=2), junctional tachycardia (n=1), and left ventricular hypertrophy (n=1). Echocardiographic features were: altered longitudinal global strain (87%), left ventricular (84%), valvular (61%) and septal (68%) hypertrophy, bull’s eye strain pattern (58%), pericardial effusion (35.5%), sparkling myocardium (32%), diastolic dysfunction (26%), dilated cavities (25%), pulmonary hypertension (19.4%), and aortic stenosis (3%). The most recurrent signs on cardiac MRI were: late enhancement (39%), left ventricular hypertrophy (33%), and abnormalities in myocardium nulling (25%). Median troponin was 0.40 ng/ml [0.07; 70.25] and BNP was 3918 pg/ml [1056; 12 563]. Positive cardiac fixation on bone scintigraphy confirmed ATTR-CA (n=3). Biopsies, serum, urine, and medullar investigations showed AL-CA lambda (n=8) and kappa (n=5). AA-CA was observed with sarcoidosis (n=1), and ankylosing spondylitis (n=1). Patients were treated with: chemotherapy (n=11), Tafamidis (n=2), and Infliximab (n=2). Outcomes were documented as complete (n=3) or partial remission (n=4), and death (n=8). Conclusion: CA is often misdiagnosed or discovered at an advanced stage. Thus, a better knowledge of the disease and screening of at-risk patients is of paramount importance for a timely diagnosis and better prognosis. Purpuric lesions in a patient with AL CA. Periorbital ecchymosis in a patient with AL CA. Submission ID: 1739 ALL IN ONE: THE 3 P PARADOXICAL EMBOLIC STROKE AND PULMONARY EMBOLISM IN A PATIENT WITH A PATENT FORAMEN OVAL EL MIRE WAFA, EL HAJJI YASMINE, ADDOU AHMED YOUSSEF, AOUDAD MOHAMED, MARZOUKI KAMAL, BENOMAR ALI, BENYASS AATIF, TAZI MEZALEK AMALE MOROCCO Background: Paradoxical embolism associated with patent foramen ovale (PFO) is a rare cause of ischemic stroke that should be investigated. Its association with a pulmonary embolism (PE) is a rare phenomenon. Objective: managing anticoagulation of pulmonary embolism during the acute phase of ischemic stroke and its value in preventing recurrence of stroke in the context of PFO. MODERATED POSTER SESSION
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