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The article presents the case study of a 30-year-old man with dyspnea decubitus. Topics include reporting a history of exacerbating dyspnea progressive and fatigue developing for 6 months; and associated with an increase in the volume of the two lower limbs taking the bucket without notion of family cardiovascular pathology and without particular antecedents.

Nous rapportons un cas dans le but d'évaluer le diagnostic électrocardiographique d'un syndrome de Brugada. Il s'agissait d'un homme de 43 ans, d'origine Indienne, qui était venu en consultation pour douleur thoracique aigue. Il était hypertendu grade II non traité et il avait un antécédent de mort subite familial (le père à l'âge de 40 ans). Son ECG montrait un aspect de bloc de branche incomplet droit avec sus décalage descendant du segment ST, avec aspect en dôme au niveau précordial droit et la coronarographie était normale, ce qui nous a permis de poser le diagnostic de syndrome de Brugada de type I. Le patient a pu bénéficier d'une pose de défibrillateur automatique implantable à la Réunion et d'un suivi régulier.

La pancardite aigue à Staphylococcus aureus est une maladie grave avec une morbi-mortalité importante qui nécessite un diagnostic et une prise en charge rapide. Elle est souvent à bas bruits et d'évolutions aiguë chez les patients immunodéprimés. Nous présentons le cas d'un homme diabétique de 40 ans, chez qui a été diagnostiquée une endomyopéricardite aigue à Staphylococcus aureus sur valve mitrale native, révélée par une tamponnade purulente (figure 1). L'évolution a été marquée par l'apparition aigue à l'échographie trans thoracique d'une végétation avec présence d'une fuite au dépend de la valve mitrale et d'une atteinte myocardique (figure2). Le patient a été traité par un drainage chirurgical et une antibiothérapie adaptée au long cours, mais n'a pas pu bénéficier d'une chirurgie sur sa valve mitrale. Son état clinique et biologique s'est amélioré progressivement. Une échographie de contrôle à 1 mois n'a pas retrouvé la végétation de la valve mitrale, ni de majoration de la fuite (figure3). Le diabète est un terrain favorisant les infections, il peut être méconnu ou révélé par des complications infectieuses (1); comme notre cas ici présent, où l'infection péricardique primaire a été une complication du diabète avec comme porte d'entrée une infection ORL. Ici, la découverte d'une infection a Staphylococcus aureus au niveau du péricarde peut engendrer sur une courte période une atteinte endomyocardique complétant le tableau de pancardite. Ce germe est le plus souvent identifié en cas d'endocardite d'évolution suraiguë (2). L'échocardiographie trans-thoracique a été la pièce maitresse du diagnostic chez notre patient. Elle est rapide et non invasive et présente une excellente spécificité pour les végétations (98%) (3). : Devant une infection à Staphylocoque aureus chez les immunodéprimés, la recherche d'atteinte endomyopéricardique doit être évoqué vu la virulence du germe; la pancardite est une pathologie encore très présente dans les pays en développement mais sous diagnostiquée et la prise en charge se limite au traitement médicamenteux en absence de plateau technique. [ABSTRACT FROM AUTHOR]

Introduction: Chest pain is one of the different elements of orientation for the diagnosis of acute coronary syndrome. Sometimes its clinical presentation is misleading. The objective of this study was to describe the characteristics of chest pain during an acute coronary syndrome in the cardiology department of the Joseph Raseta Befelatanana University Hospital Center, Antananarivo, Madagascar., Methods: We carried out a cross-sectional, descriptive study of 10 months from January 2019 to October 2019. All patients diagnosed with acute coronary syndrome during this period were included., Results: Sixty-five cases were included. A "typical chest pain" was only encountered in 7.7% of cases. Advanced age (p = 0.04) and sedentary lifestyle (p = 0.03) were associated with the occurrence of silent myocardial ischemia, and. hypertension with a prolonged duration (≥15 minutes) of chest pain (p = 0.03). Dyslipidemia was associated with atypical irradiation of chest pain (p = 0.003). Alcoholism had an impact on pain triggered by effort (p = 0.01) and relieved by rest (p = 0.04)., Conclusion: The current symptomatology of acute coronary syndrome is increasingly atypical. Knowledge of the factors that can influence the different characteristics of chest pain could serve as a benchmark in clinical practice in our population., Competing Interests: Liens d'intérêt Les auteurs ne déclarent aucun lien d'intérêt., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

Libman-Sacks endocarditis is a rare cardiac manifestation systemic lupus erythematosus, in which there is a sterile vegetation in the heart valves. There is a significant risk of infective endocarditis. Our patient was a 38 year old woman with persistent fever from two months with inflammatory polyarthralgia, fixed at the wrists and ankles. She was febrile at 39 ° C, had a mitral systolic murmur 2/6 and painful swelling of the wrists and ankles. We have objectified an inflammatory syndrome, blood cultures were negative. The dosage of anti-nuclear antibody was positive with a mottled appearance, as well as anti-DNA antibodies. The Doppler echocardiography had objectified vegetations in the mitral and aortic valves. Clinical, biological and morphological improvements were obtained after antibiotic and corticosteroid combination. We can conclude that Libman-Sacks endocarditis evolution is favorable in the absence of an associated antiphospholipid syndrome (APS). Always fear in all cases a surinfection. The treatment is based on the combination antibiotic-corticosteroid-synthetic antimalarial., Competing Interests: Les auteurs ne déclarent aucun conflit d'intérêts.

We here report the case of a 38-year old woman with dilated cardiomyopathy induced by hypocalcaemia secondary to hypoparathyroidism. The patient had low calcium level (30 mg/L) and echocardiography showed dilated-hypokinetic cardiomyopathy with reduced left ventricular ejection fraction (31.4%). She received calcitherapy associated with vitamin D3 and her evolution was marked by the normalization of the size of the cardiac cavities and of the left ventricular ejection fraction after normocalcemia., Competing Interests: Les auteurs ne déclarent aucun conflit d´intérêts.

Aim: Cardiovascular diseases (CVDs) are a global challenge but the burden in sub-Saharan African (SSA) countries is less well documented than elsewhere. We aimed to describe the key cardiometabolic risk factors in four SSA countries., Methods: A cross-sectional, multi-national, hospital-based study was carried out among adults (> 35 years) across four SSA countries from 12 December 2011 to 7 February 2013. Risk factors were defined using the World Health Organisation and International Diabetes Federation guidelines., Results: Of the 844 adults (57.4% female, mean age 52.6 years), 76.6% were urban residents. The predominant CVD risk factors were hypertension (74.1%), obesity (36.2%) and excessive alcohol consumption (25.6%). Diabetes (17.7 vs 10.0%), obesity (42.8 vs 16.8%) and hypercholesterolaemia (25.8 vs 18.0%) were more prevalent among the hypertensive subjects (all p < 0.007) than the normotensives. The metabolic syndrome (39.4%) was more common in women and hypertensive subjects., Conclusions: Hospital patients in SSA countries present with excessive rates of cardiometabolic risk factors. Focus on their prevention and control is warranted.

Introduction: This study aimed to identify patients at risk for venous thromboembolism (VTE) among all patients hospitalised, and to determine the proportion of at-risk hospital patients who received effective types of VTE prophylaxis in sub-Saharan Africa (SSA)., Methods: A multinational, observational, cross-sectional survey was carried out on 1 583 at-risk patients throughout five SSA countries., Results: The prevalence of VTE risk was 50.4% overall, 62.3% in medical and 43.8% in surgical patients. The proportion of at-risk patients receiving prophylaxis was 51.5% overall, 36.2% in medical and 64% in surgical patients. Low-molecular weight heparin was the most frequently used prophylactic method in 40.2% overall, 23.1% in medical and 49.9% in surgical patients., Discussion: This study showed a high prevalence of VTE risk among hospitalised patients and that less than half of all at-risk patients received an American College of Clinical Pharmacy-recommended method of prophylaxis., Conclusion: Recommended VTE prophylaxis is underused in SSA.

Introduction: Schistosomiasis, a parasitic disease, is endemic in many areas in the world. Schistosome eggs can be found in human tissues or organs, including the eye. These eggs can produce inflammatory granuloma. We report a unique and exceptional clinical case of periocular localization of schistosome granuloma., Observation: A 12-year-old girl, living in a schistosomiasis-endemic region, presented an inflammatory subconjunctival tumor in one eye. This tumor regressed but did not completely disappear with treatment. Complementary tests showed a slight eosinophilia (500/mm(3)) in the blood and S. mansoni ova in the stools. A biopsy was performed, revealing an inflammatory granuloma with epithelioid and giant cells rich in eosinophilic polynuclear. The immunohistochemical study showed no cells with anti-CD1 and anti-CD30, excluding histocytosis X type lesion., Conclusion: Although considered as exceptional, periocular localization of schistosome granuloma must be proposed, based on epidemiological, clinical and paraclinical results. Schistosomiasis may be considered as an origin of an inflammatory subconjunctival tumor found in endemic areas.