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Cardiac rehabilitation is still underused in Africa, despite its cost effectiveness widely demonstrated around the world. Aim: To evaluate the results of a cardiac rehabilitation program in the first Senegalese outpatient center in low resource context. Patients and Method: We carried out a prospective and interventional study. It compared on one hand a group of coronary patients at baseline and after 6 months of our rehabilitation program and on the other hand a control group of patients not enrolled in rehabilitation. Results: We included 70 patients (30 in the rehabilitation group and 40 in the control group). After rehabilitation, the functional capacity improved: 6.99 ± 2.9 Mets at M0 vs 8.8 ± 2.23 Mets at M6, p = 0.0001. Patients of intervention group significantly increased motivation to lifestyle changes and knowledge about their disease. We found better control at 6 months of hypertension (84.50% vs 33.70%, p = 0.003), diabetes (70.00% vs 26.70%, p = 0.0042), LDL cholesterol (33.00% vs 5.00%, p = 0.002) in the group “Rehabilitation”. Prevalence of psychosocial issues like anxiety and depression decreased in intervention group: 50.00% at M0 to 23.33% at M3 (p = 0.021), then 30.00% at M6 (p = 0.18). Return to work and resuming sexual activity were not significantly different. Conclusion: Comprehensive cardiac rehabilitation program, with low cost equipment in a short duration, could have real benefits in the management of coronary artery disease by reducing anxiety and depression, improving treatment compliance, control of cardiovascular risk factors, lifestyle changes and disease knowledge.

We here report a case of an acute cephalic vein thrombophlebitis in a 34-year-old female patient with no known thromboembolic risk factors and no medical history or ongoing treatment. We present the images of her diagnosis, which was made in the presence of a painful and indurated hyperchromic cord of the arm and confirmed by Doppler ultrasound. In the absence of deep extension of the thrombus, his management was limited to a symptomatic treatment without anticoagulation and the symptomatology was amended without complication or recurrence.

Patient: Female, 34-year-old Final Diagnosis: Spontaneous coronary artery dissection Symptoms: Chest discomfort Medication:— Clinical Procedure: — Specialty: Cardiology Objective: Unusual clinical course Background: Spontaneous coronary artery dissection (SCAD) is a well-known cause of acute coronary syndrome. ST-segment elevation myocardial infarction (STEMI) is the most common presentation of SCAD, which can be complicated by sudden cardiac death (SCD). Conservative management is the cornerstone of treatment except in case of ongoing ischemia or large myocardial compromise. Case Report: A 34-year-old woman presented with an anterior STEMI, diagnosed by the Emergency Medical Service (EMS) team, which performed fibrinolysis. SCD resulting from ventricular fibrillation occurred soon after thrombolysis was started. Her pulsed was palpable following defibrillation, and she was immediately intubated. A coronary angiogram (CA) showed total occlusion with dye staining contrast of the proximal left anterior descending (LAD) coronary artery. Echocardiogram showed a severe drop in the left ventricular ejection fraction (LVEF 20%). She was treated with dobutamine and intra-aortic balloon pump implantation because of her poor hemodynamic status. Rescue angioplasty was performed with a drug-eluting stent implanted from the left main stem toward the proximal LAD. However, she developed hemorrhagic shock due to active liver bleeding that was surgically treated. At 3 months, she was asymptomatic, her LVEF had improved (45%), and elective CA showed quite normal coronary arteries. Optical coherence tomography showed residual hematoma as “lunar crescent” and stent under-expansion. The latter was fixed by post-dilatations. Conclusions: Our case adds to the evidence that thrombolysis leads to poor outcomes in patients with SCAD, as reported in numerous reports. OCT was used to confirm, a posteriori, the diagnosis of SCAD. Rescue angioplasty was necessary in our patient due to poor hemodynamic status following unsuccessful fibrinolysis.