Venous Thromboembolic Disease in the Cardiology Department of the Nianakoro Fomba Hospital in Segou (HNF)

Venous thromboembolic disease (VTE) is a nosological group that consists mainly of deep vein thrombosis (DVT) and pulmonary embolism (PE). The objective of our study was to determine the hospital prevalence of VTE in this Nianakoro Fomba Regional Hospital (HNF) in Ségou, Mali, to describe the sociodemographic aspects of these patients and the therapeutic possibilities in this locality. Materials and Methods: We conducted a prospective descriptive study from June 2019 to June 2020 in the cardiology department of the HNF of Ségou. All patients of all ages and both sexes who had VTE on clinical and paraclinical criteria (pulmonary Angio scan and/or venous Doppler echo) during the study period were included. Result: 31 patients were included out of 366 hospitalized patients, with a hospital prevalence of 8.47%. The 41-60 and 61 - 80 age groups were both dominant with 35.48% of cases each. The female sex was the most represented with 58.06% of cases and a sex ratio of 0.97. High blood pressure (hypertension) was the preeminent cardiovascular risk factor in 32.2% of cases and predisposing factors for VTE were dominated by immobilization (41.94%), peripartum (16.13%) and heart failure (16.13%). Dyspnea and chest pain were the frequent reasons for consultation with 93.54% and 83.87% of cases respectively and 6 patients (19.35%) had calf pain. More than 3/4 of the patients had tachypnea or 90.32% and tachycardia in nearly 74.19%. The clinical probability of VTE was intermediate at 51.61% according to the Wells score. D-Dimers were elevated in 38.70%, or all 12 patients who performed it. The electrocardiogram (ECG) recorded a sinus rhythm in 93.54% of cases, a right branch block and atrial fibrillation (AF) in 35.48% and 6.45% of cases, respectively. Dilation of the right ventricle was present in 64.51% of cases with PAH in 61.29% on cardiac Doppler ultrasound. In the majority of cases (82.15%) it was a massive bilateral proximal and distal pulmonary embolism. Treatment was based on low molecular weight heparin (HPBM) and antivitamin K (AVK) in all patients (100%). No bleeding incidents;the average hospital stay was 10 days and an intra-hospital mortality rate of 29%.

Epidemiological, Clinical and Therapeutic Patterns of Venous Thromboembolic Disease in Cancer Patients Followed up in Two Reference Hospitals in Cameroon

Background: Cancer increases the incidence of venous thromboembolic disease (VTE), which represents a significant cause of morbidity, mortality, and economic burden in cancer patients. Objective: We aimed to describe the epidemiologic, clinical, and therapeutic pattern of VTE in cancer patients followed-up in two reference hospitals in Cameroon over the past ten years. Methods: This was a cross-sectional retrospective study conducted in the oncology department of the General hospitals of Yaoundé and Douala. We included the medical records of all patients aged 18 years and above who had active cancer with a confirmed diagnosis of VTE from 2010 to 2021. Results: We analysed 408 patients’ medical records. The prevalence of VTE was 7.6%. All those having VTE had solid tumours. There were twenty (64.5%) cases of deep venous thrombosis, five (16.1%) cases of pulmonary embolism, and three (9.7%) cases of both. Poor performance status and chemotherapy were independently associated with the development of VTE. Most of the patients were treated with compression stockings and low molecular weight heparin. Conclusion: VTE prevalence is high among cancer patients in Cameroon. It is most frequent in solid tumours originating from the genitourinary system, the lung, the pancreas, and the brain.

Venous Thromboembolic Disease and Thrombolysis at the YaoundéEmergency Center during the Past Five Years, Cameroon

Background: Venous thromboembolic disease (VTE) is a clinical entity whose two clinical manifestations are deep vein thrombosis (DVT) and pulmonary embolism (PE). It is a frequent and severe disease in Cameroon, thus constituting a significant public health problem. We aimed to describe VTE management in the Yaoundé Emergency Center, in particular the use of thrombolysis. Methods: This was a retrospective study on patients hospitalized at the Yaoundé Emergency Center for DVT and/or PE from January 1, 2015, to December 31, 2020. We collected clinical signs, paraclinical signs, risk factors of VTE, and management methods from each patient. Results: We recruited 106 participants. Dyspnea was the most frequent symptom;PE was the most common form of VTE in eight patients on 10. Obesity and high blood pressure were the main cardiovascular risk factors. The main clinical signs were oedema and pain in the limb for DVT, dyspnea, and tachycardia for PE. Heparinotherapy was the most commonly used management modality. Thrombolysis was performed in 7.5% of participants, especially in the case of hypotension or massive PE. Conclusion: In VTE management, thrombolysis remains the least used therapeutic modality in our context. Heparinotherapy remains the basis of the therapy.

Confirmed Thromboembolic Venous Disease and Clinical Probability Scores: A Transversal Study about 74 Cases Collected in the Cardiology Department of the Aristide Le Dantec University Hospital Center of Dakar

Introduction: Venous thromboembolic disease (VTED), associating deep vein thrombosis and pulmonary embolism, represents a major public health issue. The objective of our work is to correlate confirmed VTED with clinical probability scores using elements of interview and clinical examination. Methods: This was a retrospective study from January 1, 2012 to October 27, 2013. Venous thromboembolic disease was diagnosed by lower limb venous Doppler ultrasound for deep vein thrombosis and thoracic CT angiography for pulmonary embolism. Results: Our series included 74 cases of venous thromboembolic disease including 42 cases of deep vein thrombosis and 29 cases of pulmonary embolism. The average age was 48.5 ± 15.9 years. The sex ratio was 0.72. The patients came from the outpatient clinic in 67.57% of cases. The Wells score for pulmonary embolism showed excellent performance in the “Surgery/Cancer” subgroup where the low probability was zero. The revised Geneva score for pulmonary embolism, showing the same proportions of low (14.2%) and intermediate (85.7%) probability, did not discriminate the subgroup of patients with underlying heart disease from the one from a surgical or carcinological environment. Conclusion: Clinical probability scores are more suitable in surgical and oncological settings than in medical settings.