Introduction: Orthostatic Hypotension (OH) is a frequent situation during consultation in hypertensive patients. The prevalence in the general population increases with age and it is recommended to systematically...Introduction: Orthostatic Hypotension (OH) is a frequent situation during consultation in hypertensive patients. The prevalence in the general population increases with age and it is recommended to systematically search for it in patients with multiple comorbidities. The objective of this study was to determine the prevalence of orthostatic hypotension;describe their socio- demographic profile, the various clinical and paraclinical aspects and the predisposing factors of orthostatic hypotension in treated hypertensives, controlled or not. Method: This was a descriptive cross-sectional study, from January 2 to June 30, 2022 in the cardiology department of the Ignace Deen National Hospital. Included in this study were all patients who presented with orthostatic hypotension under antihypertensive treatment, regardless of age and sex, and who agreed to participate in the study. The non-inclusion criteria were hypertensive patients without OH and those who had not agreed to participate in the study. Each patient had blood pressure and heart rate measured in the supine position at room temperature and with an empty bladder. Then the measurement is taken again three (3) minutes after the switch to orthostatism. We retained the diagnosis of OH if the SBP drops by at least 20 mmHg and/or the PAD by at least 10 mmHg three (3) min after the transition to orthostatism. Our data obtained were analyzed in the Epi-info 7.4.0 software. Results: During our study period, we investigated 385 presented with OH, 12.2%. The mean age of the patients was 60.83 years ± 10.01 years and hypertensive patients, 47 of whom the M/F sex ratio was 0.81. In our study, blood pressure was not controlled in 36.2% of our patients with a predominance of grade 3 hypertension, a rate of 55.32%. Renal failure, anemia, heart failure and stroke were the main comorbidities associated with the occurrence of HO. The most incriminated factors were age with a frequency of 74.47%, followed by obesity at 44.68% and diabetes at 27.66%. BP was normally controlled with a rate of 68.8% in treated hypertensive patients with OH. It is found much more in patients using triple therapy, a rate of 61.71%. Conclusion: The prevalence of OH is high in our department. It is found much more in patients using triple therapy. The most incriminated factors were age followed by obesity and diabetes.展开更多
Ebstein disease is a rare congenital malformation whose clinical presentation differs according to the anatomical form and age of the patient. In adults, it presents mainly in the form of right or global heart failure...Ebstein disease is a rare congenital malformation whose clinical presentation differs according to the anatomical form and age of the patient. In adults, it presents mainly in the form of right or global heart failure or rhythm disorders. Survival is exceptionally long in some forms. We report the case of a 70-year-old patient with Ebstein’s disease in right heart failure.展开更多
<strong>Introduction:</strong><span style="font-family:Verdana;"> Deep vein thrombosis is a frequent disease, its origin is most often multifactorial. Venous thromboembolic disease (MVTE) a...<strong>Introduction:</strong><span style="font-family:Verdana;"> Deep vein thrombosis is a frequent disease, its origin is most often multifactorial. Venous thromboembolic disease (MVTE) and cancer are two frequently entangled pathologies. Here we report the diagnosis of deep vein thrombosis that discovered prostate cancer in an 88-year-old Guinean man. On clinical examination, there was a painful and hot swelling of the right leg, an absence of sloshing of the calf, a positive sign of Homans. The digital rectal examination revealed an enlarged prostate with an irregular surface. Cardiopulmonary auscultation was normal. The electrocardiogram showed a regular sinus rhythm at 65 cycles/min, with no sign of enlarged cavities or conduction disturbance. Venous Doppler ultrasound of the lower limbs showed the presence of an extensive acute deep venous thrombosis of the right sural vein extended to the popliteal and to the homolateral deep femoral. The reino-vesico-prostatic ultrasound c</span><span style="font-family:Verdana;">o</span><span style="font-family:Verdana;">ncluded in a heterogeneous prostatic hypertrophy with projection of a median lobe associated with a bladder of fight with an important post voiding residue evaluated at 170 ml</span><span style="font-family:Verdana;">;</span><span style="font-family:Verdana;">the rate of specific antigen of the prostate PSA was at 84.87 ng/ml. The pathology analysis made after a prostate biopsy puncture concluded with an adenocarcinoma with a Gleason score of 3.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The association of venous thromboembolic disease (MVTE) and neoplasia is frequent. The existence of active cancer in a patient is a known risk factor for MVTE and, conversely, the discovery of a first episode of deep vein thrombosis (DVT) or pulmonary embolism (PE) may be the mode of revelation of cancer.</span>展开更多
Observation: This patient was a 40-year-old housewife with dysphonia, physical asthenia, palpitations, fever and cervical tumefaction that had been going on for 2 months, no known cardiovascular risk factor, such as m...Observation: This patient was a 40-year-old housewife with dysphonia, physical asthenia, palpitations, fever and cervical tumefaction that had been going on for 2 months, no known cardiovascular risk factor, such as medical history, ischemic stroke. Heart sounds were regular at 110 bpm, blood pressure = 120/80 mmhg, to the lungs there are sibilant rattles. Elsewhere, there is a painful left lateral cervical tumefaction febrile to the touch. Temperature = 38°C. The rest of the exam is peculiar. Conclusion: Jugular vein thrombosis is a rare variety of unusual localization of venous thromboembolism. It must be suspected in the presence of a painful cervical swelling and confirmed by magnetic resonance imaging or to scan with contrast or ultrasound. Anticoagulant therapy should be instituted as soon as possible to avoid the formidable complication of pulmonary embolism.展开更多
文摘Introduction: Orthostatic Hypotension (OH) is a frequent situation during consultation in hypertensive patients. The prevalence in the general population increases with age and it is recommended to systematically search for it in patients with multiple comorbidities. The objective of this study was to determine the prevalence of orthostatic hypotension;describe their socio- demographic profile, the various clinical and paraclinical aspects and the predisposing factors of orthostatic hypotension in treated hypertensives, controlled or not. Method: This was a descriptive cross-sectional study, from January 2 to June 30, 2022 in the cardiology department of the Ignace Deen National Hospital. Included in this study were all patients who presented with orthostatic hypotension under antihypertensive treatment, regardless of age and sex, and who agreed to participate in the study. The non-inclusion criteria were hypertensive patients without OH and those who had not agreed to participate in the study. Each patient had blood pressure and heart rate measured in the supine position at room temperature and with an empty bladder. Then the measurement is taken again three (3) minutes after the switch to orthostatism. We retained the diagnosis of OH if the SBP drops by at least 20 mmHg and/or the PAD by at least 10 mmHg three (3) min after the transition to orthostatism. Our data obtained were analyzed in the Epi-info 7.4.0 software. Results: During our study period, we investigated 385 presented with OH, 12.2%. The mean age of the patients was 60.83 years ± 10.01 years and hypertensive patients, 47 of whom the M/F sex ratio was 0.81. In our study, blood pressure was not controlled in 36.2% of our patients with a predominance of grade 3 hypertension, a rate of 55.32%. Renal failure, anemia, heart failure and stroke were the main comorbidities associated with the occurrence of HO. The most incriminated factors were age with a frequency of 74.47%, followed by obesity at 44.68% and diabetes at 27.66%. BP was normally controlled with a rate of 68.8% in treated hypertensive patients with OH. It is found much more in patients using triple therapy, a rate of 61.71%. Conclusion: The prevalence of OH is high in our department. It is found much more in patients using triple therapy. The most incriminated factors were age followed by obesity and diabetes.
文摘Ebstein disease is a rare congenital malformation whose clinical presentation differs according to the anatomical form and age of the patient. In adults, it presents mainly in the form of right or global heart failure or rhythm disorders. Survival is exceptionally long in some forms. We report the case of a 70-year-old patient with Ebstein’s disease in right heart failure.
文摘<strong>Introduction:</strong><span style="font-family:Verdana;"> Deep vein thrombosis is a frequent disease, its origin is most often multifactorial. Venous thromboembolic disease (MVTE) and cancer are two frequently entangled pathologies. Here we report the diagnosis of deep vein thrombosis that discovered prostate cancer in an 88-year-old Guinean man. On clinical examination, there was a painful and hot swelling of the right leg, an absence of sloshing of the calf, a positive sign of Homans. The digital rectal examination revealed an enlarged prostate with an irregular surface. Cardiopulmonary auscultation was normal. The electrocardiogram showed a regular sinus rhythm at 65 cycles/min, with no sign of enlarged cavities or conduction disturbance. Venous Doppler ultrasound of the lower limbs showed the presence of an extensive acute deep venous thrombosis of the right sural vein extended to the popliteal and to the homolateral deep femoral. The reino-vesico-prostatic ultrasound c</span><span style="font-family:Verdana;">o</span><span style="font-family:Verdana;">ncluded in a heterogeneous prostatic hypertrophy with projection of a median lobe associated with a bladder of fight with an important post voiding residue evaluated at 170 ml</span><span style="font-family:Verdana;">;</span><span style="font-family:Verdana;">the rate of specific antigen of the prostate PSA was at 84.87 ng/ml. The pathology analysis made after a prostate biopsy puncture concluded with an adenocarcinoma with a Gleason score of 3.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The association of venous thromboembolic disease (MVTE) and neoplasia is frequent. The existence of active cancer in a patient is a known risk factor for MVTE and, conversely, the discovery of a first episode of deep vein thrombosis (DVT) or pulmonary embolism (PE) may be the mode of revelation of cancer.</span>
文摘Observation: This patient was a 40-year-old housewife with dysphonia, physical asthenia, palpitations, fever and cervical tumefaction that had been going on for 2 months, no known cardiovascular risk factor, such as medical history, ischemic stroke. Heart sounds were regular at 110 bpm, blood pressure = 120/80 mmhg, to the lungs there are sibilant rattles. Elsewhere, there is a painful left lateral cervical tumefaction febrile to the touch. Temperature = 38°C. The rest of the exam is peculiar. Conclusion: Jugular vein thrombosis is a rare variety of unusual localization of venous thromboembolism. It must be suspected in the presence of a painful cervical swelling and confirmed by magnetic resonance imaging or to scan with contrast or ultrasound. Anticoagulant therapy should be instituted as soon as possible to avoid the formidable complication of pulmonary embolism.