Epidemio-Clinical, Therapeutic and Evolutive Aspects of Pulmonary Embolism in Young Subject in the Cardiology Department in Point “G” Hospital University Center Bamako

Objective: The purpose of this work was to determine the epidemiological, clinical and evolutionary aspects of the pulmonary embolism of the young person in the cardiology department of the University Hospital Center (CHU) Point G in Bamako-Mali. Methodology: This was an analytical study from January 01, 2018 to December 31, 2018 in the CHU Point G cardiology department, including all patients hospitalized during this period. Results: Of 1379 hospitalized patients, 19 patients were concerned by pulmonary embolism of the young person. The prevalence of pulmonary embolism of the young person was 1.37%. The most affected age group was 21 - 30 (47.4%) of patients. The predominance was female (89.47%) with a gender ratio of 0.11 in favour of women. The average age in the series was 29.79 years with extremes of 16 years and 40 years. Factors predisposing to pulmonary embolism were dominated by peri partum, cardiomyopathy and obesity with 47.3%, 31.57% and 21.1%, respectively. The dominant signs were chest pain and dyspnea in 94.7% and 89.5% of cases respectively. Pulmonary embolism was unlikely in 60.52% according to the Geneva and Wells score simplified. At the thoracic angioscanner, the embolism was bilateral in 52.6% of cases and distal in 36.8% of patients;in 10 patients who performed cardiac ultrasound, pulmonary arterial hypertension (70%), dilation of the right ventricle (20%) and left ventricular dilation (40%). Hyper leucocytosis (47.4%), anemia and low prothrombin rate (TP) (22.2%) were the most found biological abnormalities. More than 2/3 (68.5%) our patients had an intermediate mortality risk according to the PESI (Pulmonary Embolism Severity Index) score. The average hospital stay was 10 days. Hospital mortality was 10.5%. Conclusion: The pulmonary embolism of the young person is a frequent, serious and multifactorial pathology and the female sex is most affected especially during peri partum periods, hence the need for preventive measures. Clinical signs are not specific and based on the assessment of clinical probability. Pulmonary angioscanner remains the confirmation review in our context.

Partial Ventricular Atrioventricular Canal Aged about a Case

Introduction: The partial ventricular atrioventricular canal is a congenital heart malformation of the ostium primum type of variable surface that can reach the single atrium where the interatrial septum is no more than a cephalic muscular vestige attached to the roof of the atrium. His diagnosis at the age of 73 is not a common situation. The interest of this clinical case that we report lies in the peculiarity of its mode of discovery and its evolution under medical treatment. Observation. He was a 73-year-old patient with no known cardiovascular risk factor and has since been at about 18 years of age with heart failure syndrome with progressive dyspnea, cough and edema of the lower limbs, but never explored for lack of financial means, and the evolution was enamelled by episodes of cardiac decompensation, the last of which dated back to 03/07/2018 justifying a hospitalization in our service. Cardiac ultrasound shows a partial atrioventricular canal. The care was medical. Conclusion: The atrioventricular canal is a congenital heart disease complex of poor prognosis.