CARDIOVASCULAR JOURNAL OF AFRICA • Kenya Cardiac Society July 2023 21 AFRICA Conclusion Efforts to improve diagnostic and management strategies for AMI in sub-Saharan Africa are essential. Increasing awareness among healthcare professionals regarding atypical AMI presentations, improving access todiagnostic tools likeECGandechocardiography, and enhancing availability of PCI are crucial steps. A coordinated approach involving healthcare providers, policymakers, and stakeholders is necessary to address these challenges and improve outcomes for AMI patients in sub-Saharan Africa. The successful outcome of the percutaneous coronary intervention in this case highlights the importance of timely and appropriate interventions in improving patient prognosis and quality of life. Submission ID: 32 PATIENT CHARACTERISTICS AND TREATMENT OUTCOME AMONG HYPERTENSIVE PATIENTS IN KENYA 2023-CROSSSECTIONAL STUDY YUSUF MAHAT Background As the global burden of NCDs continues to rise, tracking treatment outcomes is a priority goal of public health programs. Two-thirds of the burden of NCDs and its complications are reported in Low- and Middle-Income Countries (LMIC). It is therefore essential to determine the demography of hypertensive patients and identify factors linked to poor treatment outcome. Method The study was conducted in nine counties that have implemented electronic health records system (SPICE) for hypertension and diabetes management, from March 2021- March 2022. SPICE is an end-to end platform that provides custom dashboards for real-time tracking of both individual and aggregate patient data and generates customized Ministry of Health reports, which are then uploaded into the country’s DHIS2 platform. After descriptive analysis we used logistic regression to establish predictors of patient characteristics and treatment outcome among hypertensive patients. Results We analyzed data for 42,483 hypertensive patients. 10,692(25%) were male and 31,791(75%) were female. Blood pressure was significantly better controlled among women as compared to men (72.8% vs 71.5%; P value =0.04). Poor control was more significant among the obese as compared to the participants with normal BMI (29.7% vs 25.6%; P value < 0.0001). Lower control rate was noted among the age group 41 –60 yrs. though not statistically significant. Patients with only hypertension achieved better controls of their blood pressure as compared to those who had a comorbidity of diabetes (72.5% vs 66.6%; P value = 0.0001). Conclusion The study provides a national insight on hypertensive patient’s characteristics and their effect on control levels. Poor control is noted among men and patients with high BMI highlighting the need for specific gender-based interventions and nutritional support and counselling. Submission ID: 33 NON-INVASIVE DIAGNOSTIC MEASURES IN CARDIAC AMYLOIDOSIS: A CASE SERIES WAGANA L. N. MURIITHI, GACHOYA ALEX Background In the past, cardiac amyloidosis was considered a rare condition due to the paucity of data available on the subject. This resulted in possible underdiagnosis and, consequently, a lack of accurate epidemiological information regarding the condition. This case series aims to share our experience in monitoring three patients suspected to have the condition and subsequently underwent noninvasive diagnostic measures for evaluation. Case Series Case 1: T.W.G. an 80-year-old male hypertensive patient with poor drug compliance and poor follow-up presented with uncontrolled blood pressure. An initial diagnosis of hypertensive heart disease was made. However, he later presented with worsening signs and symptoms of heart failure despite being on an adequate treatment regimen. Therefore, he was sent for further non-diagnostic evaluations including a cardiac magnetic resonance imaging which favored infiltrative cardiomyopathy as the more likely diagnosis. Case 2: B.W.G. a 73-year-old female referred for a cardiologist’s review after presenting with signs and symptoms of heart failure. The initial cardiac evaluation indicated a probable diagnosis of infiltrative cardiomyopathy. She was, therefore, sent for other non-invasive diagnostic tests which further supported the initial findings. Case 3: S.K.G. an 80-year-old with asymmetric ventricular hypertrophy on initial cardiac evaluation. Subsequently, he was referred for cardiac magnetic resonance imaging. However, the results did not align with those typically associated with infiltrative cardiomyopathy, leading to the discontinuation of further evaluation. Conclusion Significantly, the outlined case series suggests that a potential non-invasive diagnostic pathway for cardiac amyloidosis could be established. This pathway would greatly depend on heightened physicians’ awareness and clinical suspicion of the condition, inevitably, changing the narrative of this previously underdiagnosed condition. As a result, it would pave way for the continued research and pharmacological advancements aimed at reducing themorbidity and mortality rates associated with this complex condition. Introduction Amyloidosis is a multisystem disorder in which specific precursor proteins misfold and aggregate into insoluble amyloid fibrils which get deposited in specific tissues [9]. This pathologic process often results in organ dysfunction, with the heart, kidneys, GI tract, and the nervous system being the most commonly affected organs. Cardiac amyloidosis (CA) occurs when the aforementioned proteins get deposited in the extracellular space of the myocardium [3, 12]. The two common types of CA include immunoglobulin light chain amyloidosis (AL) and transthyretin amyloidosis (ATTR) [1, 3, 6, 12]. Results The patient responded well to the percutaneous coronary intervention (PCI) procedure. She experienced successful revascularization of the left anterior descending artery and showed improvement in her cardiac function. Following the intervention, the patient remained asymptomatic without any chest pain. She diligently followed the prescribed medication regimen and participated in cardiac rehabilitation. Regular check-ups were scheduled to monitor her progress, and she continued to do well during the follow-up period.
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