Epidemiological, Clinical and Coronary Angiography Aspects of Acute Coronary Syndrome in the Cardiology Department of the Hospital Mother-Child “Le Luxembourg”Mali

Introduction: Cardiac catheterisation plays a fundamental role in the management of acute coronary syndrome. These explorations require heavy, complex and costly equipment and a large team of doctors, nurses and technicians with highly specialized training. Aims: To describe epidemiological, clinical and coronary angiography aspects of patients with acute coronary syndrome. Patients and Methods: Descriptive study from September 2019 to December 2023 in the Cardiology Department of the Hôpital Mère-Enfant of Bamako. Inclusion criteria were patients admitted for coronary angiography with the diagnosis of acute coronary syndrome. Results: During the study period, 1253 patients underwent coronary angiography, 596 of whom had acute coronary syndrome as an indication, representing a hospital frequency of 47%. Sex-ratio was 2.10. Mean age of patients was 58.5 ± 11.39 years. ST elevation acute coronary syndrome was the most common indication with 63.92% of cases. High blood pressure was the main cardiovascular risk factor with 58.7% of cases, and radial access approach was used in 98% of cases. Coronary angiography was pathological in 91.70% of cases (n = 548). Patients with lesions of anterior interventricular artery were 73.73% of cases. Tritruncal lesions accounted for 40.63% of cases. Conclusion: ST elevation acute coronary syndrome is the most frequent manifestation of acute coronary syndrome. Anterior interventricular artery is most often the culprit lesion for our patients.

Prognostic Factors Associated with Aortic Dissection at the Cardiac Intensive Care Unit of the Point “G” Hospital University Center, Bamako, Mali

Objective: The purpose of this study was to describe the prognostic factors associated with aortic dissection with the cardiology intensive care unit of the Point “G” Hospital University Center. Methodology: This was a descriptive transversal study from January 2010 to February 2017 that included all inpatients during this period. Results: Of 6912 patients admitted, 23 patients were admitted for an aortic dissection, a frequency of 0.33%. Of these, (6) six were under age 50 (26.1%) and the majority age group was 50 - 69 years old. Cardiovascular risk factors were high blood pressure, smoking, and diabetes with 73.9%, 60% and 13% of cases, respectively. At the clinic, chest pain and dyspnea were the main symptoms with respectively 65.2% and 52.2% and with 56.5% asphygmy was associated with pain. Para-clinically, renal failure and anemia were the major laboratory abnormalities found with respectively 43.75% and 31.25% of cases. Doppler echocardiography revealed lesions associated with aortic dissection. In the thoracic angioscan, the aortic dissection was type A (43.5%) and 56.5% type B. The co-morbidities, the associated lesions and the hemodynamic state of the patient indicate the degree of urgency. The treatment was medical. The evolution was full of complications with 52.2% of deaths including 7 (seven) type A patients. Intra-hospital death was 26.1%. Other complications were heart failure (47.8%), the renal failure (43.75%) and an aortic aneurysm (34.8%). Conclusion: Aortic dissection is a life-threatening medical and surgical emergency.