Particularites Diagnostiques Et Pronostiques De La Dissection Aortique Au Cnhu-Hkm De Cotonou, Benin : A Propos De 6 Cas En 2017

Aortic dissection (DA) defined by longitudinal cleavage of the aortic wall, at the level of the media from an intimal breach, is a diagnostic and therapeutic emergency. Out of a total of 467 hospitalized patients, we reported 6 cases of aortic dissection (DA) observed at CNHU-HKM, Cotonou, in 2017. The patients were 53.33 years old (33-65 years old), and they comprised of 4 women and 2 men. Hypertension was present in 5 patients. Chest pain, the most common telltale sign, was found in 5 patients but typical only in 2 cases. Three (3) patients had severe hypertension when they were admitted, and 2 had a differential arterial pressure of at least 20 mmHg between the arms. The breath of aortic insufficiency was present in 4 patients. Chest X-ray has contributed to the diagnosis in the 4 cases where it was prescribed. Cardiac Döppler ultrasonography was perfomed in 5 patients, while the ECG gave no contribution to the diagnosis. The diagnostic confirmation was made by the aortic CT scan in all patients and the AD was type A in 5 cases and type B in 1 case according to the Stanford classification. All patients received medical treatment and only 1 patient received both medical treatment and surgery. The outcome was fatal in 5 patients: death of the patient with type B dissection and 4 deaths out of 5 for type A

Prevalence De L’insuffisance Cardiaque Au Cours De La Grossesse Et Dans Les Suites De Couches En Milieu Hospitalier A Parakou En 2015

Introduction: Heart failure is one of peripartum complications which contribute to maternal mortality. But the epidemiological features of this disease are not well known in Benin. This paper aims at studying the prevalence and associated factors of heart failure during pregnancy and the postpartum in Parakou in 2015. Methods: It was a descriptive and analytic cross sectional study scheduled from March to July 2015. We recruited systematically all pregnant or parturient women, met in Parakou’s hospitals. The inclusion criteria were the presence of at least one cardiovascular symptom. Diagnosis of heart failure was made by using the guidelines of the European Society of Cardiology and of the American Society of Echocardiography. Results: During the survey, 2503 pregnant or parturient women were admitted and 25 (0,99%) were diagnosed with heart failure. Dyspnea was the main symptom (96%). Heart failure was caused by peripartum cardiomyopathy(84%), hypertensive cardiomyopathy (12%) and rheumatic heart disease (4%). Heart failure was more prevalent in patients with the following conditions: age≥30years (p=0,001), low socioeconomic level (p=0,02), multigestational status (p=0,002) and multiparity (p<0,001). The management of heart failure was classic. The main difficulty noted was financial problems with 36% of patients unable to afford the treatment. No case of death was counted during the study. Conclusion: In Parakou, heart failure occurs mostly during the post partum period. Dyspnea was the main symptom. The main etiology was peripartum cardiomyopathy. The associated conditions were age≥30years, low socioeconomic level, multigestational status and multiparity