Background Prevalence of coronary artery disease is between 7-13 percent in urban and 2-7 % in rural India1. The alarm in rise in the prevalence of coronary risk factors like diabetes, hypertension, dyslipidemia, smoking, central obesity and physical inactivity2. The correlation between these risk factors and the severity of coronary atherosclerosis, assessed by angiography which may be either single or multivessel is less consistent with studies reporting conflicting results 3,4. Therefore our study aims to understand the proper correlation between risk factors and severity of coronary artery disease in an Indian population Methods This study was conducted in the department of cardiology, NIMS hospital Hyderabad which receives patients from the urban as well as rural areas of Telangana. the patients admitted in the department of cardiology, NIMS hospital Hyderabad that presented with acute coronary syndromes and diagnosed to have coronary artery disease (single vessel/multivessel disease) on coronary angiography taken for study. Sample Size is 150 Results Among the 150 subjects, males were 111(74%) and females were 39(26%). Mean age of the study population is 55.2 ± 11.4. Among SVD group 73.65% were males &26.3% were females. Among MVD group 76.2% were males & 23.7% were females. Mean age for SVD was 53±14.4 years, while mean age foe MVD was 58.6±14.5 years. For ACS mean age of presentation for females is 60.7±11.4 and for males mean age of presentation is 55.1±12.6. MVD (57.2%) were more common among smokers than SVD. In <45 years age group SVD (69.2%) were more common than MVD (30.8%). In 45- 70 years age group and >70 years age group MVD were more common than SVD with 69.6% and 66.6% respectively, which is statistically significant. MVD (60%) were more common among hypertensives than SVD. Among non-hypertensives MVD (41.8%) was less common than SVD (58.2%) MVD was common among all age groups, which is statistically signicant. Among STEMI group SVD (58.3%) was more common than MVD (41.7%). Among NSTEMI group MVD (62%) was more common than SVD (38%).Correlation between groups was statistically significant. Among SVD study group, LVEF was commonly between 30-45% & very few with LVEF <30% MVD was associated with more severe LV dysfunction as compared to SVD in acute MI. The difference in ejection fraction between the two groups was statistically significant P value=0.0002. In hospital MACE Among SVD there was 1 MI (due to stent thrombosis) who had to TVR (primary PCI) & rest were asymptomatic and discharged in normal state MVD there were in hospital deaths (due to refractory cardiogenic shock) rest were asymptomatic and were discharged in normal state. This difference between the two groups was statistically insignificant. Conclusion Multivessel disease in ACS were seen more commonly among elderly as compared to young subjects where single vessel disease were more common. Females especially elderly more commonly have multivessel disease. Mean age for multivessel disease was higher than single vessel disease. Among <45 years age group, SVD was more prevalent among smokers, obese and physically active. Multi vessel disease is more prevalent among patients with risk factors like diabetes, hypertension, dyslipidemia and physically inactive. Subjects with family history of premature CAD presented early and correlated well with prevalence of SVD.NSTEMI presented more with multi vessel disease. In echocardiographic wall motion analysis, a depressed regional segment of infarcted area with remote hyperkinesis predicted SVD where as remote area hypokinesis predicts more multivessel disease. In hospital outcomes were seen among multi vessel disease as compared to single vessel disease although not statistically significant. Show less

Objective To describe the epidemiological, clinical and arterial Doppler ultrasound aspects of abdominal aortic aneurysm (AAA). Material and Methods This is a prospective study with descriptive and analytical aims carried out from January 2019 to March 2022 (3 years) at the cardiovascular exploration center (CEC) "Saint-Esprit" of the association of the people's doctors for the research on cardiovascular diseases (AMP-MCV), at the clinic "Le Printemps" and at the University Hospital of Kara. All patients who underwent arterial Doppler ultrasound of the lower limbs for any reason in these centers during the study period were included. Ultrasound scans were performed or confirmed by a physician with a diploma specializing in vascular Doppler ultrasound. Results We retained 32 Doppler ultrasound scans out of 739 performed for AAA with a frequency of 4.38%. The mean age was 73.5± 9.07 years. The sex ratio M/F was 1.4. The cardiovascular medical history (84.38%) found was: hypertension (33.33%), diabetes (18.52%), dyslipidemia (33.33%) and a combination of diabetes and hypertension (14.81%). The circumstances of discovery were: downstream MI ischemia (72%), incidental finding on abdominal ultrasound (15.63%) and De bakey sign (6.25%). The location of the aneurysms was subrenal (84.4%), suprarenal (9.4%) and both (6.2%). AAAs were fusiform (71.9%) and saccular (28.1%). The size of the aneurysms was greater than 5 cm in 78.17% of patients. High blood pressure increases the probability of the occurrence of subrenal AAA while dyslipidemia increases the occurrence of fusiform AAA. Diabetes increases the probability of occurrence of AAA larger than 7cm. AAAs were thrombosed in 75% of patients. There were extensions of the aneurysms to the iliac arteries in 70.59%. Downstream embolic complications represented 46.88%, in the form of occlusions and tight stenoses. Spontaneous mortality was 81.24%. Conclusion Arterial Doppler ultrasonography is a very important tool in the screening, positive and lesion diagnosis of AAA. The risk factors for AAA are: age over 60 years, male gender, hypertension, diabetes and dyslipidemia. Early detection remains essential, because the spontaneous prognosis is poor. Show less

Introduction Rheumatic heart disease is mostly common in low-income or developing parts of the world, such as Sub-Saharan Africa, with a high morbidity and mortality rate. There are few data that are available in Chad on rheumatic heart disease. Our objective was to study the clinical, echocardiographic, therapeutic, and progressive aspects of rheumatic heart disease at the Renaissance University Hospital Center and the National Reference Teaching Hospital in N’Djamena, Chad. Patient and methods This was a prospective, multicenter and observational cohort study, covering a consecutive series of patients consulted and/or hospitalized for rheumatic heart disease, documented by an echocardiogram from January 2015 to January 2021. Results Among the 4456 patients consulted and/or hospitalized, 398 cases of rheumatic heart disease (8.9%) were collected, and 364 patients had met the inclusion criteria. The mean age was 31.2 ± 14.4 years, and 193 patients (53%) were female. On admission, heart failure was present in 214 patients (58.8%), ischemic stroke in 10 patients (2.7%) and supraventricular arrhythmias such as atrial fibrillation in 94 patients (25.8%) and atrial flutter in 6 patients (1.6%). Mitral regurgitation was observed in 49.7% (n=181) of cases, aortic regurgitation in 33.2% (n=121), mitral stenosis in 31.3% (n=114), and aortic stenosis in 7.7% (n=28). At least two valvular disorders were combined in 48.4% of cases. A surgical intervention such as a heart valve replacement and/or valvuloplasty was performed in 80 patients (22.2%). At least one rehospitalization was noted in 56.9% of patients. Forty-two of the 150 patients free of heart failure at inclusion (28%) had experienced the first episode of decompensated heart failure during follow-up. On the other hand, in 119 patients (55.6%), it was the second episode of decompensated heart failure. Other progressive complications included atrial fibrillation (13.8%), thromboembolic complications (6.3%), infective endocarditis (6.0%) and prosthetic valve dysfunction (1.4%). Altogether, the mortality rate was 10.4%. It was 9.9% in non-operated patients compared to 12.5% in operated patients (p=0.49). Conclusion The present study shows that morbidity and mortality of rheumatic heart disease remain high in our context and often affect children, young adults, and women. Treatment is essentially based on cardiac surgery which is not available in Chad. Show less

Ebstein’s anomaly is a rare congenital heart disease. It is usually associated with other congenital defects, particularly atrial septal defect/patent foramen ovale (PFO). We report here the case of Ebstein's disease revealed in a 23-year-old adult admitted for palpitations and exertional dyspnoea. He was in heart failure. The EKG showed atrial flutter . Cardiomegaly was present with a cardiothoracic index of 0.7. On echocardiography, the apical displacement of the tricuspid septal leaflet was 15 mm/m2 , the Celermajer index was Grade 3.  There was a large thrombus floating in the right atrium. While awaiting surgical management, the patient was being treated with diuretics, digitalis and anticoagulants. Show less