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The aortic aneurysm is the 13th leading cause of death in Western countries. The incidence of thoracic aortic aneurysms is estimated at 4.5 cases per 100,000. The diagnosis is often made on a chest x-ray or other imaging tests, such as an echocardiogram done for other heart diseases. Echocardiography is the first test to assess the diameter of the ascending aorta and its progression over time. Most patients are first assessed and followed up with spiral thoracic computed tomography with injection of contrast medium, supplemented by 3-dimensional reconstruction of the aneurysm in order to improve the accuracy of measurements, identification of its proximal part and distal. When dilation of the ascending aorta reaches the critical diameter of 50 mm, there is a risk of aortic dissection or rupture. Supravalvular aneurysms are treated by replacing the ectatic portion with a Dacron&#174 tube in the supracoronary position. Aortic root aneurysms, including coronary ostia, require tube replacement, reimplantation of coronary ostia, as well as surgery on the aortic valve. In this article, we report a case of aneurysm of the aortic root and the ascending aorta treated by aortic valve replacement and the ascending aorta associated with the Cabrol hemi-mustache technique and we review the literature.

Objective: The work aimed to describe the etiological and evolutionary aspects of cardiogenic shock in the intensive care unit of the cardiology department (USIC) of the G-spot hospital in Bamako, Mali. Materials and Methods: This was a descriptive cross-sectional study from January 1, 2018 to April 30, 2019 that included all patients admitted to the USIC during this period. Each patient benefited from individual data support with systematic recording of socio-demographic, clinical, complementary and therapeutic data and analyzed with the SOFTWARE SPSS 20.0 French version. Results: The study involved 40 patients out of 311 patients hospitalized in USIC, representing a hospital frequency of 12.86%. Males were the most affected (60%) with a sex ratio of 1.50. The modal class was 41 - 60 years with extremes at 18 years and 89 years. Cardiovascular risk factors were dominated by HTA (27.50%), diabetes and tobacco, each with 22.50%. The general signs were tachycardia (90%), oxygen desaturation (77.50%), impregnable blood pressure (62.50%), agitation (52.50%) and an oliguria (70%). At the electrocardiogram the rhythm was sinus (80%), it was an atrial fibrillation (15%), a ventricular tachycardia (10%) and signs of coronary ischemia (necrosis in 35% and ST over shifted in 20% of cases). At cardiac doppler ultrasound,the left ventricle was dilated (50%), the right cavities dilated (30%), segmental kinetic disorder (40%), the left ventricular systolic function (FEVG) impaired (75%) and valve disease (10%). Biology noted hyper-creatinemia (65%), hyper-glycemia (12.50%), anemia and hyponatremia with 20% frequency each. Among etiology, ischemic heart disease accounted for 57.50% followed by pulmonary embolism 20%, dilated valve cardiomyopathy 7.50% and chronic pulmonary heart 2.50%. The trend in the majority of cases was unfavorable with 60% of deaths. Chronic pulmonary heart and pulmonary embolism were the deadliest with a frequency of 100% and 87.50% respectively. Conclusion: Cardiogenic shock is an infrequent condition with a high mortality of a prognosis. Ischemic heart disease is the most common etiology of the disease.

Introduction: Cardiac myxomas represent the most frequent forms of primary tumors of the heart. The most frequent location is the interatrial septum. We report the clinical case of a myxoma of the left atrium and discuss its epidemiological and therapeutic aspects through a review of the literature. Observation: This was a 41-year-old female patient who presented with sudden rotational dizziness associated with vomiting. MRI revealed multiple punctiform bilateral supra and subtentorial strokes of different ages, recent and semi-recent, suggesting an embologenic etiology. Transesophageal echocardiography found a large pedunculated, homogeneous, avascular tumor hanging from the interatrial septum. The patient is operated on urgently under cardiopulmonary bypass for resection of a large tumor located in the left atrium. The pathological examination concluded with the diagnosis of myxoma of the left atrium. The postoperative follow-up was straightforward and the patient was discharged from the hospital via home hospitalization. Conclusion: The diagnosis of cardiac myxomas is suspected in the presence of symptoms associated with echocardiographic images of intracardiac masses and confirmed by histological study. Embolic accidents are one of the formidable complications of myxomas. Surgical management is urgent, especially in the presence of predictive morphological features of embolism on echocardiography.

Introduction: Peripartum cardiomyopathy (PPCM) is a heart failure whose etiology is still unknown. The aim of work was to study peripartum cardiomyopathy in its epidemiological, clinical, paraclinical and therapeutic aspects at the Tombouctou hospital. Methods: This is a descriptive cross-sectional study carried out in the Medicine Department of the Timbuktu hospital from January 1 to December 31, 2019. It concerned patients who presented heart failure between the 8th month of pregnancy and the first 5 months postpartum. Results: During the study,23 patients were collected. Average age of the patients was 23.50 ± 3.50 years with extremes of 16 and 34 years. Incidence of Peripartum cardiomyopathy (PPCM) was 1/345 pregnancies. Average parity was 3.20 with extremes of 1 and 8. Symptoms appeared at postpartum with 87% of cases. A significant delay in diagnosis was observed. Global heart failure was the mode of decompensation with 70%. Electrocardiographic signs were mainly sinus tachycardia (87%) and left ventricular hypertrophy (83%). Cardiac ultrasound showed in all cases dilated cardiomyopathy and it was associated with thrombus in left ventricle cavity for three cases. Left ventricular ejection fraction was severely impaired in 70% of cases. Pulmonary hypertension was significant in 52%. Most commonly drugs we used in our series at acute stage were duretics: furosemide 100% and spironolactone 70% (100% and 70%) and ACE inhibitors (90%). Beta-blockers (bisoprolol and carvedilol) were used in 15 patients. Bromocriptine (prolactin inhibitor) was used for 2 patients. Conclusion: Peripartum cardiomyopathy is a serious cardiac complication of pregnancy of unknown cause, common in the African population.

Tuberculosis is a public health problem in Mali. Pulmonary localization is the most frequent and extra-pulmonary involvement, in particular serous, is possible. In this study, we analyze our results of surgical pericardial drainage in tuberculous pericarditis. Methodology: We carried out a retrospective study at the CHU Point G over a period of five years from January 2012 to December 2017. The histological examination carried out on all the surgical specimens made it possible to retain the diagnosis of tuberculous pericarditis. Results: We identified and operated on 49 cases of tuberculous pericarditis, i.e. 70% of the pericardial drainage performed during the same period. The average age was 31.5 years (28 men and 21 women). The most common clinical signs were dyspnea (61.2%), chest pain (26.6%) and fever (12.2%). Pericardial drainage with pericardial biopsy was performed by xiphoid route in all of our patients. The mortality and morbidity rates were 4.1% and 8.2%, respectively. Conclusion: Pericardial tuberculosis attacks are frequent in Mali. The etiological diagnosis is based on the histology of the pericardial biopsy which can only be obtained surgically.

Background: Pulmonary embolism (PE) is a severe form of venous thromboembolic disease. In Africa, prevalence of PE in hospitalized medical patients varies among studies. Objective: Aim of this work was to study the epidemiological, clinical, therapeutic and evolution aspects of PE in the medicine department of Mali’s Hospital Bamako-Mali. Methodology: This was a retrospective cross-sectional study carried out from January 01, 2017 to December 31, 2020 in the medicine department of Mali’s hospital Bamako, including all inpatients admitted for PE during the study period. Results: Of 1814 hospitalized patients, 54 patients had pulmonary embolism. Hospital frequency of pulmonary embolism was 2.97%. Predominance was female and sex-ratio M/F was 0.38. Mean age in our series was 54.24 ±1.19 years. Predisposing factors to pulmonary embolism were dominated by obesity 37%, high blood pressure 35.2% and history of cardiovascular disease 20.4%. Dominant signs were dyspnoea and chest pain in 83.3% and 70.4% of cases respectively. Probability of pulmonary embolism was high in 40.7% according to Wells score. Patients with right heart failure were 22.2%. EKG showed sinus tachycardia70.4% and S1Q3 aspect 7.4%. Heart right chambers were dilated at transthoracic echography 42.6%. Obstruction was bilateral at chest angio CT for 51.9% and proximal for 42.6%. Deep venous thrombosis was associated at EP in 16.6%. Treatment was low weight molecular heparin followed by vitamin K antagonist or direct oral anticoagulant. One patient was successfully treated by thrombolysis. Hospital mortality was 16.7%. Conclusion: PE is a serious disease probably underdiagnosed. It is responsible of important mortality.

Congenital heart diseases are abnormalities of heart that occur during intrauterine life. Our work aimed to study the epidemiological and echocardiographic aspects of congenital heart disease with Cardiology Department of the Tombouctou hospital. This was a descriptive cross-sectional study from November 2018 to December 31, 2019 on Doppler echocardiography reports from patients admitted to the Cardiology department. The probes used were 3.5 and 5 MHz on an Esaote Mylab40 device. The inclusion criteria concerned patients of both sexes under the age of 16, hospitalized or followed in the cardiology department for cardiac symptoms and having benefited from a cardiac Doppler ultrasound. Results: During the study period, 370 echocardiographic examinations were performed and revealed 20 cases of congenital heart disease with a prevalence of 5.45%. The female sex was the majority 13/7 cases which makes a sex ratio of 0.54. Heart murmurs were the main reason for requesting cardiac Doppler ultrasound with the 13 out of 20 cases of congenital heart disease (65%). Interventricular communication was represented by 15 cases (75%). Congenital heart disease is a reality in Africa. Its frequency and reported series are underestimated due to the inaccessibility of Doppler echocardiography.

Resume But de l’etude Decrire les caracteristiques cliniques, electrocardiographiques et echocardio-graphiques du cœur d’athlete. Patients et methodes Il s’est agi d’une etude transversale realisee d’aout 2015 a fevrier 2016 dans la ville de Bobo-Dioulasso au Burkina Faso. Des sportifs de haut niveau d’entrainement (au moins 8 heures d’entrainement hebdomadaire, depuis plus de six mois quel que soit le type de sport) ont beneficie : d’un examen clinique, d’une electrocardiographie et d’une echographie cardiaque de repos pour rechercher des modifications cardiaques electriques, morphologiques et fonctionnelles. Resultats Les 192 sportifs ayant un cœur d’athlete inclus avaient un âge median de 24 ans (IIQ : 21–27). La mediane de l’anciennete de la pratique du sport de haut niveau etait de 6 ans (IIQ : 4–8) et celle des seances d’entrainement hebdomadaire de 10 heures (IIQ : 10–10). La consommation de tabac, alcool, the/cafe, medicaments et/ou boissons energisantes etaient rapportee respectivement chez 4,2 %, 7,3 %, 99 %, 53,4 %. Un antecedent de malaises d’effort etait rapporte par 4,7 des athletes. Les modifications electriques etaient presentes chez 92,1 %. La bradycardie sinusale etait l’anomalie la plus frequente (75,0 % des cas). La prevalence de la dilatation de l’oreillette gauche et celle du ventricule gauche etaient respectivement de 72,4 et 22,4 %. Celle de l’hypertrophie du ventricule gauche etait de 9,0 %. Conclusion Chez l’athlete de haut niveau d’entrainement les prevalences des modifications electriques, morphologiques et fonctionnelles etaient elevees. Celles-ci necessitent d’etre connus par les praticiens afin de les differencier de la pathologie cardiaque.

Elite sport results in electrocardiogram changes. Some are minor, others are likely to cause sudden death. The authors intended to describe the electrocardiogram features of top athletes at rest in Bobo-Dioulasso. This descriptive transversal study was carried out from August 2015 to February 2016 in the cardiology department of CHU Sanou Souro in Bobo-Dioulasso. The study sampled top athletes aged 17 to 35 with at least eight hours’ training per week for more than six months regardless of the type of discipline. Two hundred top-level athletes from 4 sport disciplines were included. The median age of athletes was 24 years (IIQ: 21 -27). The median duration in high level sport was 6 years (IIQ: 4 - 8) and the median length of weekly training sessions was 10 hours (IIQ: 10 - 10). Only 4% of the athletes had already conducted an Electrocardiogram (ECG). ECG abnormalities were reported in 90.5% of cases and sinus bradycardia was the most common abnormality reported in 72.5% of cases. Left ventricular and left atrial hypertrophy were reported in 44% and 34.5% of cases respectively. Early repolarization syndrome was registered in 47% of cases. Practicing top-level sport activity can result in electrical changes with athletes. These changes need to be identified by practitioners so that the can differentiate them from heart diseases.

L´insuffisance cardiaque est une pathologie frequent au sein de notre population. Son incidence n´a cesse de croitre dans nos pays en voie de developpement. Il s´agit de decrire les aspects epidemiologiques, therapeutiques, et de determiner les facteurs influencant l´observance therapeutique des patients suivis pour insuffisance cardiaque dans le Service de Cardiologie du CHU de Kati. Il s´agit d´une etude transversale descriptive, concernant tous les patients admis en hospitalisation ou suivis en ambulatoire dans le service pour insuffisance cardiaque, de janvier a avril 2018. Au total 93 cas ont ete inclus, le sexe masculin a ete predominant (52 cas) soit un sex ratio de 1,26. La tranche d´âge (60 - 74 ans) a ete la plus representee 30,1 % des cas. Les menageres ont represente 25,8 % de l´echantillon, plus de la moitie des patients (68,8%) n´ont pas eu de subvention de leur prise en charge. L´ecart de regime a ete la principale cause de decompensation (34,4%), les raisons economiques etaient le principal motif de rupture therapeutique (40,6%). Les diuretiques (91,30%) ont ete les plus prescrits. Le cout global moyen d´hospitalisation a ete de 203.289 francs CFA. L´insuffisance cardiaque constitue une affection frequente en pratique cardiologique au Mali, le diagnostic doit etre precoce, pour mettre en œuvre les therapeutiques efficaces, avec des couts raisonnables et accessibles au cas par cas.

Le sport de haut niveau d´entrainement entraine des modifications électrocardiographiques. Certaines sont bénignes, d´autres sont péjoratifs à l´origine de mort subite. Les auteurs se proposent de décrire les caractéristiques électrocardiographiques de repos chez les sportifs de haut niveau d´entraînement de la ville de Bobo-Dioulasso. Il s´est agi d´une étude transversale descriptive allant d´août 2015 à février 2016 dans le service de cardiologie du CHU Sanou Sourô de Bobo-Dioulasso. Elle a inclus des sportifs de haut niveau d´entrainement âgés de 17 à 35 ans ayant au moins huit heures d´entrainement par semaine depuis plus de six mois quel que soit le type de sport. Deux cents sportifs de haut niveau d´entrainement de 4 disciplines sportives ont été inclus. L´âge médian des athlètes était de 24 ans (IIQ: 21-27). L´ancienneté médiane de la pratique du sport à haut niveau d´entrainement était de 6 ans (IIQ: 4-8) et la durée médiane des séances d´entraînement hebdomadaire de 10 heures (IIQ: 10-10). Seulement 4% des athlètes avaient déjà réalisé un électrocardiogramme (ECG). L´ECG présentait des anomalies dans 90,5% et la bradycardie sinusale était l´anomalie la plus fréquente rapportée dans 72,5% des cas. L´hypertrophie ventriculaire gauche et celle atriale gauche étaient rapportées respectivement dans 44% et 34,5%. Le syndrome de repolarisation précoce était retrouvé dans 47% des cas. La pratique du sport de haut niveau d´entraînement peut occasionner des modifications électriques chez l´athlète. Celles-ci nécessitent d´être connus par les praticiens afin de les différencier de la pathologie cardiaque.

Objective: The work aimed at describing an epidemioclinical, therapeutic and evolutionary characteristics of patients hospitalized for aortic dissection in the cardiology department in Point “G” Hospital University Center in Bamako—Mali. Methodology: It was a descriptive cross-sectional study from January 2010 to February 2017 in the CHU Point G cardiology department, including all patients hospitalized during this period. Results: Of 6912 hospitalized patients, 23 patients were concerned by aortic dissection. The prevalence of aortic dissection was 0.33%. The most affected age group was 50 - 69 (43.5%) of patients. The predominance was male with a sex ratio of 4.75. The cardiovascular risk factors were high blood pressure (73.9%) and smoking (60.9%). The major functional signs were chest pain (65.2%) and dyspnea (65.2%). Asphygmy (56.5%) and breath of aortic insufficiency (60.9%) were the dominant physical signs. The electrocardiogram recorded sinus tachycardia with 86.9% of patients. The radiographic of the frontal thorax showed mediastina widening (73.9%). At echocardiography, dilatation of the ascending aorta was described with 73.9% and the intimal veil (47.8%). Pericardial effusion was observed with 26.1% of patients. In the thoracic angioscan, the aortic dissection gave 43.5% for type A and 56.5% for type B. The aneurysm of the aorta was abdominal with 21.7%, ascending portion (13.0%) and descending with 8.7%. Complications were dominated by heart failure (47.8%) and aneurysm of the aorta (34.8%). The lethality was 52.2%. Conclusion: Aortic dissection is a medical and surgical emergency with poor prediction.

Background: There is a need for data on epidemiological, clinical and therapeutic aspects of ventricular septal defect among children in Sub-Saharan Africa. Objective: The aim of this study was to determine the prevalence, epidemioclinical, echocardiographic, therapeutic and evolutionary aspects of ventricular septal defects (VSD) in the pediatric department of the University Hospital Center (CHUSS) of Bobo-Dioulasso. Methods: This study was a descriptive cross-sectional study, conducted from November 2013 to December 2016. All children aged 1 to 179 months seen at the pediatric consultation in CHUSS were included. CIV was confirmed with Doppler echocardiography. Results: Out of 36,240 children who received consultation in the pediatric ward of CHUSS during the study period, one hundred (100) cases of them had congenital heart disease representing a hospital prevalence of 2.76%. This was diagnosed with Doppler echocardiography. Of these, 88% were VSD isolated or associated with other cardiac malformations. Isolated form was reported in 54.3% of cases. The average age at diagnosis was 39.6 months. The sex ratio was 1.05. Perimembranous topography and hemodynamic type 2 were the highest, representing 56.8% and 35.2% respectively. The indication for surgical repair was recommended for 81.8% of the cases, but only 9.7% of these cases benefited from cardiac surgery. The rest were for medicalcare with a high proportion of lost to follow-up (48.9%). Conclusion: VSD is the most common congenital heart disease. Its care is mainly surgical. This cardiac surgery is non-existent in Burkina Faso. The design of multidisciplinary strategies associated with an optimization of the means of the countries of Sub-Saharan Africa could improve the management of this cardiopathy.

Le diabète est un puissant facteur de risque cardio-vasculaire indépendant. Les auteurs se proposent de décrire les anomalies électrocardiographiques et échocardiographiques observées chez les diabétiques de type 2 suivis dans le département de médecine du CHUSS. Une étude transversale descriptive a été réalisée d’avril à septembre 2014 incluant tous les diabétiques de type 2 consentants. Tous ont bénéficié d’un recueil de données cliniques, d’une électrocardiographie et d’une échocardiographie doppler. Un total de 155 diabétiques a été enquêté. L’âge médian de la population était de 55 ans (IIQ: 47-64) à prédominance féminine (Sex ratio 0,5). Les anomalies électrocardiographiques étaient représentées par les troubles de la repolarisation (31%) et les troubles du rythme auriculaire (16,12%). Sur le plan échocardiographique, l’hypertrophie du ventricule gauche (VG) était rapportée dans 20,64%. L’oreillette gauche était dilatée dans 14,19%, une dilatation VG dans 1,3% des cas. Une altération de la fraction d’éjection VG était notée dans 3,87% des cas. Les entités nosologiques étaient représentées par la cardiomyopathie hypertensive dans 27 cas (54%), la cardiopathie ischémique dans 19 cas (38%), la cardiomyopathie dilatée dans 2 cas (4%) et la cardiomyopathie diabétique dans 2 cas (4%). L’insuffisance cardiaque était notée dans 22 cas (44%) indépendamment de l’atteinte cardiaque présentée. Les anomalies électrocardiographiques et échocardiographiques sont fréquentes dans la population de diabétique de type 2 au CHUSS de Bobo-Dioulasso. Une meilleure collaboration entre cardiologues et diabétologues et la mise en place d’un plateau technique adéquat de dépistage serait un préalable pour une meilleure stratification du risque cardiaque dans cette population.

Le but de ce travail était de déterminer la prévalence de l'HTA chez les personnes âgées ainsi que leurs connaissances sur cette maladie. Il s'est agi d'une étude descriptive transversale qui s'est déroulée dans la ville de Bobo-Dioulasso d'Octobre à Novembre 2015 sur les sites d'intervention de l'association d'aide aux personnes âgées « KAFOLI ». Les sujets inclus étaient les personnes âgées de 60 ans et plus, hypertendus ou non et qui désiraient participer à l'étude. Les sujets étaient considérés comme hypertendus lorsqu'ils avaient une pression artérielle systolique ≥ 140mmHg et/ou une pression artérielle ≥ 90mmHg ou lorsqu'ils avaient un traitement antihypertenseur. Les données sociodémographiques, cliniques, les facteurs de risque associés ont été recueillis. Les connaissances sur l'HTA recueillies portaient sur les connaissances générales sur l'HTA, les sources d'informations sur l'HTA. 88 sujets ont été inclus dans notre étude. Il y avait 56 femmes et 32 hommes soit un sex-ratio de 0,57. L'âge médian était de 71 ans (IIQ: 66-76). La prévalence de l'HTA était de 61,36% et était associée à la connaissance de l'HTA et à la consommation d'alcool. 68,18% des patients avaient des connaissances sur l'HTA. La majorité était suivie dans les Centres de Santé de premier niveau par des infirmiers (64,81%). Cette étude a mis en évidence une forte prévalence de l'hypertension artérielle chez les personnes âgées à Bobo-Dioulasso. Ces personnes étaient en majorité sensibilisées sur la maladie. Leur suivi était assuré dans la majorité des cas par un personnel infirmier.

Even though vaccination against FMD is back on the agenda, mainly as an emergency measure and to a lesser extent as part of an eradication programme, clear-cut data on viral shedding from vaccinated cattle is still lacking. The mandatory testing of a large number of parameters in cattle, which cannot be repeated in all lots, carries a considerable cost, especially in terms of cattle and feed purchases. It seems essential to perform studies under conditions which, although not implementing a biosafety level 3, guarantee a sufficient protection for both the neighbouring livestock and the animals included in the experiments. Laboratories in developing countries are expected to play a critical role in these studies., Alors que la vaccination contre la fièvre aphteuse suscite un regain d’intérêt essentiellement en cas d’urgence, et dans une moindre mesure comme vaccination-éradication, des données irréfutables sur l’excrétion virale chez les bovins vaccinés font encore défaut. L’obligation d’étudier, sur des bovins, un nombre élevé de paramètres, que l’on se gardera bien de croiser, nécessite un budget considérable, notamment pour l’achat du bétail et pour son alimentation. Il apparaît dès lors indispensable d’opérer dans des conditions qui, sans atteindre le niveau de biosécurité P3, assurent une garantie suffisante tant pour les cheptels voisins que pour les lots en expérimentation. Un rôle déterminant devrait donc être dévolu, dans ces essais, aux laboratoires des pays du Sud., Sidibe Amadou Samba, Vindrinet Robert, Camus Emmanuel, Caufour Philippe. Pour une étude de l'excrétion virale et du portage aphteux : intérêts et rôle des laboratoires du Sud. In: Bulletin de l'Académie Vétérinaire de France tome 156 n°1, 2003. pp. 45-47.