[Acute myocardial infarction in Morocco: FES-AMI registry data]. / L'infarctus du myocarde au Maroc: les données du registre FES-AMI.

BACKGROUND: Acute myocardial infarction is the most dangerous complication of coronary atherothrombosis. There are several disparities in regard to its management around the world. The aim of this study is to analyze the specificities of management of acute myocardial infarction in Morocco. METHODS: FES-AMI (Fès Acute Myocardial Infarction) is a prospective monocentric registry conducted in cardiology department of Hassan II university hospital in Fès. In this registry, we enrolled patients with acute myocardial infarction who presented within 5 days after symptom onset. RESULTS: From January 2005 to August 2015, we enrolled 1835 patients. Seventy-five percent of patients were males and mean age was 60 years old. Fifty-one percent of patients were smokers, 27% were hypertensives and 14% were diabetics. Sixty-six percent of patients had more than 2 risk factors. Time from symptom onset to hospital admission was less than six hours for 40% of the patients. Thirty-six percent of patients were admitted more than twelve hours after the onset of chest pain. Only 37% of patients received reperfusion therapy, 31% with in-hospital thrombolysis and 6% with primary angioplasty. In-hospital mortality was 7.6%. CONCLUSION: The patients enrolled in our registry have late presentation of acute myocardial infarction and less rate of reperfusion therapy. Furthermore, the majority of our patients have multiple risk factors and this result underlines the failure of preventive interventions.

[Angioplasty of saphenous vein grafts in the acute phase of myocardial infarction. Short and mid-term results]. / Angioplastie des greffons saphènes à la phase aiguë de l'infarctus du myocarde. Résultats à court et moyen termes.

The impact of the progress of interventional cardiology on the improved prognosis of myocardial infarction due to occlusion of a saphenous vein bypass graft is not well known. The aim of this study was to report the modalities and results at short and medium term of revascularisation by angioplasty of venous grafts in the acute phase of myocardial infarction. Out of a total of 870 consecutive patients treated by angioplasty in the first 6 hours of myocardial infarction with persistent ST elevation between 1990 and 2002, 16 (2%) had acute occlusion of a saphenous vein graft. Twelve of the 16 patients had previous myocardial infarction; perfusion was obtained in 7 patients. The attempt failed in 9 patients because of "no-reflow" (n=5), the extensive nature of the thrombosis (n=2) and technical failure (n=2). Three patients died in hospital, all after failed angioplasty. At 6 months, of the 13 survivors of the hospital period, 2 had been readmitted for a revascularisation procedure. At 2 years, 3 patients had died, 2 were readmitted for recurrent myocardial infarction and 8 patients remained free of a major cardiovascular event. Reperfusion by angioplasty of an occluded saphenous vein graft in the acute phase of myocardial infarction remains imperfect and the prognosis at short and medium term is poor.

[Floating thrombus in the aortic arch: a rare case of peripheral arterial embolic events (report of a clinical case)]. / Thrombus flottant de la crosse de l'aorte: une cause rare d'embolies artérielles périphériques. A propos d'un cas clinique.

Floating thrombus in the aortic arch is a rare and often under-diagnosed source of peripheral arterial embolic events. We report a case of a patient seen with arterial embolic events: ischemia of the left superior limb and transient stroke. The diagnosis was performed with transesophageal echocardiography and computed tomography. The thrombus completely disappeared after 15 days of oral anticoagulant therapy. Although rare, this diagnosis mustn't be overlooked in the search for an etiology of recurrent and disseminated peripheral ischemic events because the detrimental functional risk related to a delayed diagnosis.

[Aneurysm of the internal saphenous vein: report of a case]. / Anévrisme de la crosse de la veine saphène interne: à propos d'un cas.

Venous aneurysms of the lower extremities are rare. They have been reported in both the deep and superficial vein system. Thromboembolism is more common in aneurysms involving the popliteal vein than those involving superficial veins. We report a case of primary aneurysm of the greater saphenous vein presenting as an inguinal hernia. Sonography has confirmed the venous dilatation. we review also the clinical and therapeutic findings of venous aneurysms of the lower extremities.

[Pericardial mesothelioma. A case report]. / Mésothéliome péricardique. A propos d'un cas.

Primary pericardial mesothelioma is a rare malignancy, with an estimated incidence of 0.0022% in a large autopsy study. We report a case of primary pericardial mesothelioma revealed by a large and recurrent pericardial effusion. Through a literature review, we analyse the clinical findings of this tumor. With or without therapy, prognosis is poor.

[Myocardial infarction related to sport. Acute clinical and coronary angiographic characteristics in 16 cases]. / Infarctus du myocarde au cours d'une activité sportive. Caractéristiques cliniques et angiographiques en phase aiguë d'une série de 16 cas.

OBJECTIVE: Determination of clinical and angiographic characteristics of myocardial infarctions related to sport. METHODS: Retrospective study of acute coronary syndromes with ST elevation related to sport treated with interventional cardiology from 2006 to 2013. RESULTS: Sixteen patients were included. They are mostly men (15/16), aged 24-65 years (over 35 years old in 13 cases) with few cardiovascular risk factors, most frequently heredity or smoking. Myocardial infarctions usually occur during the practice of sports (13/16), with serious rhythmic complications in three of the cases. On angiography, most patients have single vessel disease (12/16). CONCLUSION: Myocardial infarction related to sports affects a male population aged over 35 years old with few cardiovascular risk factors, most often single vessel disease, making the preventative screening uneasy. Other studies investigating larger populations, assessing previous clinical events (symptoms, results of stress tests), evaluating the impact of competition and integrating sudden deaths would improve the screening and the treatment of sport-related myocardial infarctions.

[Giant aneurysm of the inter-atrial septum]. / Anévrisme géant du septum inter-auriculaire.

We report the case of a large atrial septal aneurysm and a review of the literature. Atrial septal aneurysm is found in 1-8% of normal subjects. Its prevalence is higher among patients with ischemic stroke. Transesophageal echocardiography is an optimal tool for the diagnosis of atrial septal aneurysm. The clinical course may be complicated by arterial embolism, but mechanical complications may also occur, as in this case. Due to the lack of general agreement, treatment options should be discussed on an individual basis for patients with atrial septal aneurysm.