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Aims: To describe the knowledge, attitudes and practices of health care personnel regarding venous thromboembolic disease prophylaxis (VTE) in the hospital setting to Parakou in 2017. Study Design: A descriptive cross-sectional study with prospective data collection. Place and Duration of Study: Departments of medicine and medical specialties, Departments of surgery and surgical specialties, Departments of gyneco-obstetrics and intensive care at the Hospital University of Parakou (CHUD-B), in northern Benin, between February 2017 and May 2017. Methodology: We included all health professionals working in these services who consented to participate. The American College of Chest Physicians (ACCP) guidelines for the management of VTE were used as the reference for the assessment of knowledge, attitudes and practices. The evaluation form consisted of two parts, one addressed to physicians and the other to paramedics. The data were analyzed with SPSS 21 software with a significance level of 5% for comparisons. Results: A total of 223 health workers participated in the study. The knowledge level of the health workers was good in 52.47%, attitudes were correct in 37.67% and practices were adequate in 4.32%. Overall, health professionals had a good knowledge-attitude-practice (KAP) score in 5.83% of the cases. Factors significantly associated with a good overall KAP score were practice on medical departments, continuing education of staff, status of doctors, knowledge of VTE guidelines and existence of VTE prevention protocols. Conclusion: Venous thromboembolic disease prophylaxis is moderately known by the health care personnel in Parakou, but attitudes and practices are not satisfactory. This highlights the need for continuous training.

Hypertension is the strongest cardiovascular risk factor worldwide. May Measurement Month (MMM) is an international campaign for blood pressure (BP) screening initiated by the International Society of Hypertension. This work aims to estimate the proportion and the levels of awareness, treatment, and control of hypertension in participants of the MMM survey in Benin in 2018. A cross-sectional survey focused on people aged ≥18 years was conducted in May 2018 in nine rural and urban areas in Benin. A sampling of volunteers was done. BP was measured following the MMM protocol. Hypertension was defined as a systolic BP ≥140 mm Hg and/or a diastolic BP ≥90 mm Hg (mean of the second and third readings) and/or taking antihypertensive medication. Linear regression was used to identify BP associations. A total of 2035 people were screened, including 55.9% women. The mean age was 44.2 ± 15.9 years. The percentage with hypertension was 35.4%. Of 721 participants with hypertension, 56.2% were aware of their diagnosis, 39.7% were on antihypertensive medication, and 13.6% were controlled (

Hypertension constitutes a major health concern worldwide and particularly in Sub-Saharan Africa. May Measurement Month (MMM) is a global initiative of the International Society of Hypertension for raising awareness of high blood pressure (BP). This work aims to determine the prevalence, awareness and levels of treatment and control of hypertension among adults participating in the MMM Campaign in Benin in 2019 (MMM19). A cross-sectional survey including volunteers aged ≥18 years was carried out in June 2019 in 13 rural and urban areas in Benin. BP measurement followed the MMM19 protocol. Hypertension was defined as a systolic BP ≥140 mmHg, or a diastolic BP ≥90 mmHg (based on the mean of the second and third readings) or taking antihypertensive medication. A total of 3637 people were screened with a female predominance (61.4%) and a mean age of 44.4 ± 16.1 years. A total of 1363 (37.5%) participants had hypertension. Of 1363 participants with hypertension: 64.5% were aware of their status and 43.9% were taking antihypertensive medication. Among 598 participants taking anti-hypertensive medication, 34.9% had controlled BP (systolic BP

Introduction: Nutritional therapy in the treatment of high blood pressure and heart failure is a real challenge in terms of compliance of sodium restriction for success of the treatment. The study aims to assess the level of patient compliance with the sodium restriction by salt consumption, prescribed by care providers and the associated factors. Materials and Methods: Total daily salt intake was estimated in a cross-sectional study of 166 hypertensive and heart failure subjects monitored in the cardiology department of the “Centre Hospitalier Universitaire - Hubert Koutoukou Maga” (CNHU-HKM), using two 24-hour recalls combined with a food frequency questionnaire for salt-providing foods. Results: Out of the study, 83.7% of patients had a daily intake above recommendations. Factors associated with the non-compliance of salt restriction were the lack of knowledge of palliative spices and herbs of salty taste (p=0.009) and the consumption of salty snack foods and salty peanuts (p=0.032). Conclusion: Nutritional education and support activities should be carried out to improve the salt reduction compliance for these patients.

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Introduction The purpose of this work was to determine the absolute cardiovascular risk (ACVR) of women using hormonal contraception in Porto-Novo. Methods We carried out a descriptive, cross-sectional study, including women at the time of renewal of a hormonal contraceptive method. Blood pressure, fasting venous blood glucose level, body mass index and electrocardiographic left ventricular hypertrophy were studied. The determination of ACVR was dual based on the World Health Organisation (WHO/ISH) and the European Society of Cardiology (ESC/ESH) models. Results The mean age of the women was 35.3 ± 8.2 years. Blood pressure and blood glucose levels were high in 24 and 1.5% of cases, respectively. Left ventricular hypertrophy was present in 7.1% of cases. A high ACVR was found in 5.2% of these women, using the ESC/ESH model. Conclusion The occurrence of women with high ACVR in this group raises the problem of cardiovascular eligibility to the contraceptive method used.

Summary Introduction: Le but du present travail etait de determiner le risque cardiovasculaire absolu (RCVA) des femmes utilisant une contraception hormonale a Porto–Novo. Méthode Nous avons mene une etude transversale descriptive incluant des femmes au moment du renouvellement d’une methode contraceptive hormonale. La pression arterielle, la glycemie veineuse a jeun, l’indice de masse corporelle et l’hypertrophie ventriculaire gauche electrocardiographique ont ete etudiees. La determination du RCVA a ete double basee sur les modeles de l’Organisation Mondiale de la Sante (OMS/ISH) et de la Societe Europeenne de Cardiologie (ESC/ ESH). Résultats L’age moyen des femmes etait de 35.3 ± 8.2 ans. La pression arterielle et la glycemie etaient elevees dans respectivement 24 et 1.5% des cas; 23.2% etaient obeses. L’hypertrophie du ventricule gauche etait presente dans 7.1% des cas. Un RCVA eleve etait retrouve chez 5.2% de ces femmes selon le modele de l’ESC/ESH. Conclusion L’existence de femmes a RCVA eleve dans ce groupe souleve le probleme de l’eligibilite cardiovasculaire a la methode contraceptive utilisee.

Background & Aims: The objective is to ascertain the pattern of potential drug-drug interactions (pDDIs) and record any observed DDIs and adverse events (AEs) in hospitalized Beninese cardiology patients from Sub-Saharan Africa and analyze all risk factors associated with DDIs and AEs. Methods: It was a prospective study in which data including AEs were assessed from medical files and interview of patients and their relatives. Patients who were treated with more than two drugs and who remained in the hospital for at least 48 hours were included. A computerized database system Pharma IAM- VIDAL version 2011 was used to identify the pattern for potential DDIs. Results: 156 patients were included in this study. The prevalence of potential DDIs was estimated at 93 % (145/156). Forty (5.1%) among 804 potential DDIs identified were observed clinically. The observed DDIs were attributable to low blood pressure (27.5%), hyponatremia (22.5%), hemorrhage (20.0%), hyperkalemia (17.5%) and nephrotoxicity (7.5%). The combination of spironolactone and furosemide resulted in hyponatremia while the combination of enoxaparin and potassium resulted in hyperkalemia. ACE inhibitor (or ARAII) in combination with furosemide resulted in the nephrotoxicity cases observed. Enoxaparin, Acetyl salicylic acid, Acenocoumarol and Clopidogrel were decreasingly involved in the pairs of drugs responsible for observed hemorrhages. 29 patients out of 156 (18.6%) had at least one AE. AEs were mainly (34.2%) of metabolic type. Severe AEs, which represented 18.4% was mostly from nephrotoxicity and metabolic disorders. More than 14 active substances multiplied the risk factor for AEs occurrence by 42, while more than 14 days hospitalization increased this risk by 42. Conclusion: This study highlights the need to optimize treatments by strictly regulating blood pressure, serum sodium and potassium levels, coagulation parameters and looking for clinical signs of hemorrhage. Physician should be aware of certain drug associations that may carry a risk of severe adverse events.

Resume Nous rapportons le cas d’un patient hypertendu diabetique, porteur d’un stimulateur cardiaque et qui a presente des precordialgies d’effort suivies de lipothymie. L’examen initial etait normal ; le seuil de stimulation ventriculaire etait de 1,125 volts (V) et les enzymes cardiaques normales. L’epreuve d’effort a reproduit les precordialgies suivies d’une perte de capture ventriculaire responsable d’asystolies. Une coronarographie a revele une stenose serree de l’interventriculaire anterieure proximale, dilatee par un stent actif. L’epreuve d’effort de controle etait revenue normale. Une thrombose du stent huit jours plus tard a entraine un syndrome coronarien aigu avec des syncopes a repetition dues a une perte de capture ventriculaire. Le seuil de stimulation ventriculaire etait alors de 2,25 V. Apres revascularisation et stabilisation de l’etat clinique du patient, ce seuil etait revenu a 1,125 V. Cette observation a bien confirme que l’insuffisance coronarienne pouvait majorer de seuil de stimulation ; elle souligne egalement l’utilite des algorithmes de capture automatique chez les patients coronariens. Le test d’effort peut non seulement contribuer a detecter l’insuffisance coronarienne mais permet aussi l’optimisation de la programmation du pacemaker.

Persistent left superior vena cava (LSVC) is a rare congenital anomaly. Its prevalence in the general population is 0.1 to 0.5%. LSVC is 5 times rarer when accompanied by an absence of the right superior vena cava (RSVC). We present the case of a 54-year-old man who carries a persistent LSVC without RSVC. Clinically, this patient presented a regular bradycardia at 40 per minute associated with a heart failure syndrome. The electrocardiogram diagnosed a complete atrioventricular block and transthoracic echocardiography showed dilated left heart cavities and a left ventricular ejection fraction of 50%. During the procedure of pacemaker implantation, the probe followed an unusual LSVC-coronary sinus-right atrium path and it was not easy to pass through the tricuspid orifice. We propose a review of the literature on this subject, focusing on the clinical implications of this malformation in cardiac stimulation and in other areas of cardiology.

Introduction : L'objectif principal etait d'etudier les facteurs associes a la survenue de l'insuffisance cardiaque aigue (ICA) chez les patients hospitalises pour un infarctus du myocarde (IDM) au Centre National Hospitalier Universitaire de Cotonou. Methodes : Au cours d'une etude retrospective descriptive menee de janvier 2011 a decembre 2013, ont ete etudies chez ces patients la frequence de l'ICA, les facteurs associes a sa survenue et la mortalite hospitaliere. Resultats : 70 patients ont ete inclus, d'âge moyen egal a 58,39 ans, dont 67,14% d'hommes. L'ICA a ete diagnostiquee dans 47,14% des cas. Les facteurs identifies associes a sa survenue etaient l'âge avance, l'atteinte electrocardiographique etendue et les comorbidites telles que les infections, l'anemie et l'insuffisance renale. 7,46% des patients etaient decedes durant l'hospitalisation soit 12,5% en cas d'ICA et 2,86% en l'absence d'ICA. Des resultats similaires ont ete rapportes par de nombreuses publications anterieures. Conclusion : L'ICA est un facteur de mauvais pronostic dans l'IDM. Une revascularisation myocardique rapide et le traitement adequat des comorbidites et des complications rythmiques permettront d'ameliorer le pronostic des patients.

La thrombose veineuse profonde (TVP) du membre thoracique est rare mais grave du fait de sa complication mortelle qui est l'embolie pulmonaire. Dans ce papier, nous rapportons cinq cas afin de contribuer a une meilleure connaissance de cette affection chez le sujet noir africain. Cinq (5) patients ayant une thrombose veineuse du membre thoracique documentee par un echo-doppler veineux ont ete observes entre le 01/01/2007 et le 31/12/2012. La prevalence a ete de 4,09% sur l'ensemble des thromboses veineuses de membre. L'âge moyen etait de 48,8 ± 13,8 ans. La sexratio (H/F) a ete de 0,67 pour les femmes. Les causes ont ete le catheter veineux peripherique (40%), les cancers (40%), et la phlebite d'effort (20%). Les signes cliniques ont ete domines, au niveau du membre atteint, par l'oedeme (100%), la douleur (80%), l'augmentation de la chaleur (80%). L'atteinte de la veine humerale a ete la plus frequente dans 80% des cas. Les complications ont ete des sequelles post phlebitiques dans deux (40%), deux cas de deces (40%) en rapport avec les comorbidites et un cas d'embolie pulmonaire. L'heparinotherapie relayee par l'antivitamine K (AVK) a ete le protocole de traitement le plus souvent utilise. Le delai moyen de suivi du traitement AVK a ete de 44,7 mois. La thrombose profonde du membre thoracique est une affection rare a Cotonou dont la cause est dominee par le catheter veineux et le cancer. La prevention de ces causes secondaires est le meilleur traitement.

Le ventricule droit à double chambre (VDDC) est une malformation cardiaque rare dans laquelle le ventricule droit est divisé en deux chambres par une bande musculaire anormale. Il est associé dans 80 à 90% à d'autres malformations. L'expression clinique est variée et dépend de l'importance de l'obstruction intraventriculaire. Nous rapportons l'observation d'une adolescente de 16 ans, présentant une forme isolée de VDDC révélée par des syncopes à répétition. Le diagnostic est fait par l'échocardiographie Döppler. La résection chirurgicale de la bande musculaire anormale a été faite avec succès.Mots clés: VDDC, adolescente, syncope, échocardiographie, chirurgieEnglish Title: Isolated double-chambered right ventricle (DCRV): a case study conducted at the National University Hospital CNHU-HKM in Cotonou, BeninEnglish AbstractDouble-chambered right ventricle (DCRV) is a very rare cardiac defect in which the right ventricle is divided by anomalous muscle bundle into two chambers. It is associated with other malformations in 80-90% of cases. Clinical presentation varies and depends on the extent of the intraventricular obstruction. We here report the case of a 16-year old teenager with isolated DCRV revealed by recurrent syncopes. The diagnosis was made using Doppler echocardiography. The patient underwent successful surgical resection of the abnormal muscle band.Keywords: DCRV, teenager, syncope, echocardiography, surgery

Background: Peripheral Artery Disease (PAD) is a real silent killer with a strong predictive value for cardiovascular cause mortality. We aim to assess the prevalence and factors associated with PAD among workers Cotonou city (BENIN).Methods: It was a cross-sectional study from June to September 2013 conducted within three societies in Cotonou area. We have done a systematic recruitment among workers, aged 18 and over, who signed the consent document. PAD was retained when ankle brachial index was âA¯Â?½¤ 0.90. Other data collected were information on cardiovascular risk factor and socio-demographic data. SPSS 17 software was used to perform data quantitative analysis.Results: We registered 989 workers aged 23 to 78 years with a mean age of 52.3 ± 9.4 years. PAD was diagnosed in 47 (4.7%) among whom 2 (4.2%) had intermittent claudication. In univariate analysis, a significantly higher prevalence of PAD was found among workers with age âA¯Â?½¥ 60 years (9.5% vs. 4.2%; p=0.015), female sex (8.0% vs. 3.8%; p=0.008), history of diabetes (11.5% vs. 4.2%; p=0.003) and hyperglycemia the date of survey (10.2% vs. 2.4%; p

Le ventricule droit à double chambre (VDDC) est une malformation cardiaque rare dans laquelle le ventricule droit est divisé en deux chambres par une bande musculaire anormale. Il est associé dans 80 à 90% à d'autres malformations. L'expression clinique est variée et dépend de l'importance de l'obstruction intraventriculaire. Nous rapportons l'observation d'une adolescente de 16 ans, présentant une forme isolée de VDDC révélée par des syncopes à répétition. Le diagnostic est fait par l'échocardiographie Döppler. La résection chirurgicale de la bande musculaire anormale a été faite avec succès.

Objectives: Challenging differential diagnosis. Background: Acute myopericarditis and ACS STEMI share the presenting triad of acute chest pain, ST segment changes, and elevated cardiac enzymes. Differentiating is not always straightforward. Case Report: We reported the clinical observation of a 70-year-old woman admitted into cardiology intensive care for acute chest pain with electrocardiographic abnormalities suggestive of acute coronary syndrome with ST elevation (ACS STEMI). Pharmacological myocardial revascularization was done. Secondary evolution in the absence of initial coronary angiography is compatible with a myopericarditis of favorable evolution under empiric antibiotherapy. Coronarography performed remotely reveals a significant stenosis of the proximal and middle circumflex. Percutaneous angioplasty was successfully performed. Conclusion: In patients with acute chest pain, ST segment changes and elevated cardiac enzymes, coronary angiography can be useful in differential diagnosis.

The main purpose was to study the right ventricular pacing threshold of patients who benefit from cardiac pacemaker’s implantation at the National Teaching Hospital of Cotonou in Benin. This was a retrospective study from January 2007 to September 2013. The right ventricular pacing threshold measured during successive checks has been studied. A threshold greater than 1 volt was considered high. The conventional causes of threshold’s rising were sought. 35 files were examined. The average threshold of our patients amounted to 1.24 ± 1.17 volts at the first control and remained high until the end of follow-up. The prevalence of threshold elevation was 17% (6/35). The causes of threshold elevation were: late displacement of the lead (1 case), faulty lead (1 case), and suspected lead’s micro dislodgment (1 case). There was no formal etiology found for 3 cases. Half of threshold elevation cases involved a problem of pacing lead. Similar findings have been reported by previous studies. This study has confirmed that threshold elevation mainly involved pacemaker lead. The premature need to change the pacemaker caused by this elevation has considerable consequences in a Beninese local context marked the lack of governmental facilities.