Background: Left ventricular non-compaction (LVNC) is a rare congenital cardiomyopathy characterized by excessive trabeculations and deep intertrabecular recesses of the left ventricular myocardium. Although increasingly recognized worldwide, LVNC remains underdiagnosed in sub-Saharan Africa due to limited access to cardiac magnetic resonance imaging and insufficient familiarity with echocardiographic diagnostic criteria. Case Presentation: We report the case of a 50-year-old woman admitted for advanced heart failure in Brazzaville, Republic of Congo. She presented with New York Heart Association class IV dyspnea and a strong family history of heart failure and sudden cardiac death. Transthoracic echocardiography revealed severe left ventricular systolic dysfunction and typical features of LVNC, including prominent apical and lateral trabeculations with a non-compacted to compacted myocardial ratio of 2.6 at end-systole. Cardiac magnetic resonance imaging, performed subsequently, confirmed the diagnosis. Medical treatment resulted in marked clinical improvement. Conclusion: LVNC is likely underrecognized in sub-Saharan Africa. This case demonstrates that careful transthoracic echocardiography, combined with clinical and familial data, can allow a reliable diagnosis even in the absence of cardiac magnetic resonance imaging. Strengthening echocardiographic expertise is essential to improve the detection and management of LVNC in resource-limited settings.

We report the case of an 80-year-old hypertensive patient who suffered an ischemic stroke. He was asymptomatic, and clinical examination revealed blood pressure asymmetry with arterial hypertension in the left arm (BP = 170/94 mmHg) and arterial hypotension in the right arm (BP = 83/62 mmHg). Doppler ultrasound of the supra-aortic trunks showed an alteration of flow in the right subclavian artery. CT angiography revealed a retroesophageal course of the right subclavian artery with significant stenosis.

Background: Heart failure (HF) is a major cause of morbidity and mortality worldwide, with a growing burden in sub-Saharan Africa. Data remain limited in Cameroon, particularly among older adults. This study aimed to describe the epidemiologic, clinical, and paraclinical profile of geriatric patients admitted for HF in two hospitals in Yaoundé. Methods: We conducted a cross-sectional study with a retrospective and prospective phase of data collection over six months (November 2021-April 2022) in the cardiology units of the Yaoundé Central Hospital and the Yaoundé General Hospital which are on our pyramid of our national health care facilities on the top. We aimed then to carry out this study in those highest level of care facilities. Patients aged ≥65 years with a diagnosis of HF based on clinical and echocardiographic criteria were included. Sociodemographic, clinical, geriatric, and paraclinical data were collected after informed patient consent. Analyses were performed using SPSS 23.0, with results expressed as means and proportions. The hospital prevalence was calculated by the ratio of patients above 65 years old admitted for heart failure over all the patients above 65 years old admitted in the selected hospitals during our period of study. We did not include in the study patients aged less than 65 years old, incomplete records and medical files without a clear diagnosis of deep veinous thrombosis (DVT) and or pulmonary embolism (PE). Results: 267 elderly patients have been admitted in those two hospitals among which 92 presented with heart failure. We included 63 elderly patients with HF, giving a hospital prevalence of 34.5% (95% CI: 28.9 - 40.2). The mean age was 75.0 ± 6.4 years. Hypertension (81.0%) and sedentary lifestyle (74.6%) were the most frequent risk factors. Acute decompensated HF was the commonest presentation (38.1%), and therapeutic non-compliance the leading precipitating factor (83.3%) for decompensation. Dyspnea (95.2%) and peripheral edema (82.5%) predominated as symptoms at presentation. On examination, jugular venous distension, hepatomegaly, ascites, basal crackles, and pulmonary congestion were frequently found. Frailty was the most common geriatric syndrome (42.9%). The majority of patients (58.7%) had HF with a preserved LVEF. Conclusion: In our context, studies on heart failure are common but to the best of our knowledge, this is the first study focusing on elderly patients. We have then found out that, the hospital prevalence of heart failure in elderly patients was 34.5% with a confidence interval of 28.9% - 40.2% which was high in our milieu due the high prevalence of uncontrolled hypertension among those group of patients. Dyspnea (95.2%) and peripheral edema (82.5%) was the predominated symptoms at presentation. Frailty was the most common geriatric syndrome (42.9%). The majority of patients (58.7%) had Left Hypertrophy associated with a preserved LVEF.

Background: Many studies have been carried out on pulmonary embolism (PE) in general in our country. But to the best of our knowledge, they have never been focused on specific stages of PE according to the last classification predicting the mortality at 5 years specially for the intermediate (IR-PE) and high risk (HR-PE) of pulmonary embolism. Objective: We describe the epidemiology and clinical pattern of intermediate and high-risk pulmonary embolism (PE) in two hospitals in Cameroon. Methods: This was a retrospective cross-sectional study carried out in two reference hospitals of Yaoundé-Cameroon on a 6 years period from January 1st, 2015 to December 31st, 2020. All complete medical records of patients aged 20 years and more, with a confirmed diagnosis of pulmonary embolism and risk stratification were included. Statistical analysis was done using SPSS version 18.0. Results: The medical records of 86 patients were analysed. The mean age was 52.5 ± 15.9 years with a sex ratio of 0.59. The cumulative prevalence of intermediate and high risk PE was 5.9%. The proportions of ILR-PE, IHR-PE and HR-PE were respectively 40.7%, 40.7% and 18.6%. Obesity, use of combined oral contraceptive pills and previous VTE were the most frequent risk factors. Symptoms were dominated by dyspnoea and chest pain and the physical sign most frequently found was tachycardia. Conclusion: Prevalence of intermediate and high risk PE remains high in our context. Risks factors and clinical manifestations are similar to the data found in the literature.

Objective: To describe the epidemiological, diagnostic, therapeutic data and access outcomes of severe pulmonary embolism (PE) in the Cardiology Department of Kara Teaching Hospital. Materials and Methods: This was a cross-sectional study with retrospective data collection, carried out from January 2022 to June 2023 in the Cardiology Department of Kara Teaching Hospital. The study included the records of inpatients for severe PE diagnosed on the basis of clinical, ultrasound and angioscan findings. Results: During our study period, 42 patients were hospitalised for PE. Of these, 13 patients were treated for severe PE (30.9%). The mean age of these patients was 52.7 years, with a predominance of women (sex ratio M/F = 0.3). The average time to admission to cardiology was 4.7 ± 2.8 days. Thromboembolic risk factors were dominated by cancer (23.1%), pregnancy and childbirth (15.4%), HIV (15.4%) and prolonged immobilisation (15.4%). Ultrasound signs of acute pulmonary heart disease were present in all patients, with thrombus in the right cavities in three patients. Thoracic angioscan showed proximal involvement in 100% of cases and bilateral involvement in 50%. Streptokinase was the only thrombolytic agent used in 12 patients. Anticoagulant treatment in the acute phase was unfractionated heparin in 53.8% of cases and low molecular weight heparin in 46.2%, followed by oral anticoagulants (77.8%) and vitamin K antagonists (22.2%). The average hospital stay was 12.3 ± 5.2 days, with an in-hospital death rate of 30.8%. Conclusion: Severe PE remains a frequent medical emergency with a high mortality rate in our department, hence the need for better organisation of care services and improved technical facilities to improve patient prognosis.

Introduction: Arterial hypertension is a major public health issue due to its increasing morbidity and mortality, largely linked to inadequate control. Objective: To determine the prevalence and determinants of blood pressure control in adults in Gabon. Patients and Methods: A multicenter, cross-sectional, descriptive, and analytical study was conducted in a hospital setting over six months in seven provinces of Gabon, including 338 hypertensive patients. Exclusion criteria were gestational hypertension, suspected secondary hypertension, acute illness, concurrent treatments, and refusal to participate. A physical examination was performed to assess blood pressure, heart rate, and anthropometric parameters. A questionnaire collected socioeconomic data, characteristics of care received, follow-up location, and health insurance status. Hypertension was considered controlled when blood pressure measured on three readings was below 140/90 mmHg. Statistical analysis was performed using Epi-Info 3.5, with significance set at 0.05. Results: The prevalence of controlled hypertension was 35%. The main factors associated with poor control included low socioeconomic status and education level, insufficient knowledge of the disease, poor adherence to treatment, and comorbidities such as diabetes. Follow-up by a cardiologist and the use of a fixed-dose combination of antihypertensive drugs were associated with better control. Conclusion: In Gabon, blood pressure control remains relatively low. This therefore necessitates improving the socio-economic status of patients, the quality of practitioners, and access to health insurance.

Background and Objectives: In Kinshasa, the capital city of the Democratic Republic of the Congo and the largest and most populous city in Central Africa, the in-hospital prevalence of heart failure is currently unknown. This study sought to determine the in-hospital prevalence of heart failure among adult patients diagnosed with a cardiovascular disease in Kinshasa. Methods: We reviewed all cardiovascular diagnoses recorded on Excel spreadsheets for adult patients admitted at Monkole Hospital between January 1, 2019, and December 31, 2019. We calculated the prevalence of heart failure diagnosis and of cardiovascular comorbidities, and we determined the odds of a heart failure diagnosis in association with cardiovascular comorbidities using logistic regression analyses. Results: Of 442 patients aged ≥ 18 years diagnosed with a cardiovascular disease at the hospital in 2019, 145 (32.8%) were diagnosed with heart failure, 97 (21.9%) were diagnosed with hypertensive heart disease, 85 (19.2%) were diagnosed with ischemic heart disease, 40 (9.0%) were diagnosed with pulmonary embolism, 32 (7.2%) were diagnosed with arrhythmia, 22 (5.0%) were diagnosed with hypertension, and 20 (4.5%) were diagnosed with cardiomyopathy. Independent predictors of a heart failure diagnosis were age ≥ 65 (adjusted odds ratio [AOR]: 3.62; 95% CI: 2.04 - 6.42), a diagnosis of ischemic heart disease (AOR: 4.17; 95% CI: 2.19 - 7.96), a diagnosis of pulmonary embolism (AOR: 6.91; 95% CI: 2.55 - 18.7), a diagnosis of hypertensive heart disease (AOR: 2.44; 95% CI: 1.37 - 4.35), age 50 to 64 (AOR: 1.90; 95% CI: 1.13 - 3.20), a diagnosis of arrhythmia (AOR: 32.1; 95% CI: 4.26 - 242.0), and a diagnosis of hypertension (AOR: 9.06; 95% CI: 1.99 - 41.2). Conclusions: Heart failure was the most frequent diagnosis among all adult patients diagnosed with a cardiovascular disease at Monkole Hospital in 2019. The one-year in-hospital heart failure prevalence of 32.8% we report is higher than the 25.6% to 42.5% in-hospital heart failure prevalences observed during 2 to 4 years in tertiary care facilities in Cameroon, Nigeria, and Togo.

Introduction: Pacing dependency is defined as the inadequacy or absence of intrinsic rhythm that can lead to bradycardia-related symptoms or cardiac arrest upon cessation of ventricular stimulation. The aim of the present work was to study it in a sample of patients followed at the CNHU-HKM in Cotonou. Method and patients: This was a descriptive, analytical cross-sectional study carried out at the University Cardiology Clinic of Cotonou from February 1 to August 1, 2023. It included an exhaustive sampling of all patients admitted as outpatients for follow-up of a cardiac implanted electronic device (CIED). The variables studied were the presence or absence of pacing dependency and the factors associated with it. Results: One hundred and eleven patients were included, aged 69.6 ± 13.7 years. The sex ratio was 0.91. The type of CIED was a pacemaker in 96.4% of patients. Complete atrioventricular block was the indication for pacemaker implantation in 76.6% of cases. On the electrocardiogram, 82% of patients had a paced rhythm. During the control by programmer, pacing dependency was found in 45.1% of cases. In multivariate analysis, female gender, preoperative complete atrioventricular block and less than 12 months of CIED wearing time were significantly associated with pacing dependency. Conclusion: This result is highly dependent on the criteria used to define pacing dependency. The associated factors identified have also been found by other authors. Other factors remain to be discovered in studies involving larger samples.