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Context and Objectives: Acute coronary syndromes (ACS) constitute a major medical emergency. In Senegal, outside the capital Dakar, there is a lack of appropriate care structures. The objective of this work was to study the ACS treatment in the city of Ziguinchor. Methodology: This was a retrospective study of acute coronary syndromes’ cases admitted to the two-level two hospitals in the city of Ziguinchor from January 1, 2016 to December 31, 2019. We included all patients with acute angina pain at rest and/or electrocardiographic changes in at least two contiguous leads. The data were analysed using sphinx V5 software. Results: 57 cases were collected. The average age was 60.1 ± 14.1 years. There was a male predominance with a sex ratio of 3.7. The majority of patients arrived at the hospital by unsafe delivery (70.5%). Symptomatology was dominated by typical angina pain (50.8%). On the electrocardiogram, a majority of acute coronary syndromes with ST segment shift were observed (70.2%). Doppler echocardiography found abnormalities in segmental kinetics in 69.8% of cases. The troponin dosage was performed in 7 patients, i.e. 12.3%. The average time of treatment was 3.4 ± 4.5 days. Medical treatment remained standard and no patient was thrombosed. The average hospitalization period was 5 ± 3.2 days. The hospital lethality was 7.2%. Conclusion: Acute coronary syndromes constitute a medical emergency. Diagnostic and therapeutic means are lacking in a city like Ziguinchor, hence the importance of good prevention.

Context and Objectives: Deep vein thrombosis (DVT) is a potentially serious affection because it can be complicated by life-threatening pulmonary embolism. Epidemiological data are scarce in Africa. The objective of this work was to describe the prevalence, risk factors and treatment of deep venous thrombosis (DVT) in Ziguinchor. Methodology: This was a retrospective study carried out at the Ziguinchor Peace Hospital from January 1, 2016 to June 30, 2020. We included in the study all patients of both sexes, aged at least 18 years and hospitalized with DVT of the lower limb confirmed by venous Doppler ultrasound. Results: A total of 64 patients were hospitalized for DVT of the lower limbs during the study, for a hospital prevalence of 3.9%. The average age of the patients was 53 years (±17.6). A female predominance was noted with an M/F sex ratio of 0.7. The main risk factors found were the age ≥ 60 years (36%) and infectious pathologies (17%). Clinical signs were dominated by lower limb pain (93.8%) and lower limb edema (92%). The lower limbs’ venous Doppler ultrasound showed a predominance of thrombosis in the left lower limb (56%). The femoral vein was the most affected in 90% of cases. The patients had all benefited from an anticoagulant treatment mainly by a low molecular weight heparin relayed from the 1st day by an antivitamin K that was acenocoumarol in 97% of the cases. The average length of hospitalization was 10 days. The complications found were pulmonary embolism (8%) and accident with anticoagulants (3%). Hospital mortality was 6%. The average cost of care was 164.000 CFA francs. Conclusion: DVT is a multifactorial pathology; its treatment requires the control of risk factors. In our study, it was more frequent in the elderly.

Introduction: Peri-partum cardiomyopathy is a rare cause of heart failure. The objective of this work was to describe the epidemiological, clinical aspects and risk factors associated with peri-partum cardiomyopathy in Ziguinchor. Methodology: This was a retrospective study from January 01, 2015 to April 30, 2020 at the Ziguinchor Peace Hospital. We included all patients hospitalized for heart failure between the 8th month of pregnancy and the first 5 months postpartum. Results: We had recorded 32 cases of PPCM, i.e. an inpatient prevalence of 2.3%. The average age of our patients was 27.19 ± 8.082 years. The multiparous (43.7%) were the most represented. Twin pregnancy was present in 28.1% of cases. Clinically, the condition occurred within the first three months postpartum in 28.1% of cases. The clinical picture was that of global heart failure in 87.5% of cases. On cardiac ultrasound, the average end diastolic diameter of the left ventricle was 58.9 ± 4.98 mm and the average systolic ejection fraction of the left ventricle was 33.19% ± 8.24%. The treatment was mainly based on diuretics (100%) and ACE inhibitors (93.8%). After 6 months, 82.1% of patients had recovered normal left ventricular systolic function. Multiple pregnancies, age over 30, and twinning were the risk factors for PPCM in our patients. Conclusion: PPCM is a rare cause of heart failure and its overall prognosis is favorable in Ziguinchor.

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.