Spontaneous coronary artery dissection (SCAD): a case report.

Spontaneous coronary artery dissection (SCAD) is often revealed by an acute coronary syndrome classified then as a MINOCA. The typical patient is a female patient with no or few cardiovascular risk factor. Our work aims to illustrate the effectiveness of medical treatment in patients with SCAD. Case Report: We report a case of a 56-year-old female patient who was admitted after 3 days of infarct-like thoracic pain related to an anterior extended ST-elevation myocardial infarction. The coronarography showed a SCAD of the left anterior descending coronary artery. The patient was discharged under medical treatment. Six weeks later, coronarography showed a perfused coronary artery. Discussion: Most cases of SCAD present as acute coronary syndrome. Coronary angiography remains the 'first-line' examination. The use of endocoronary imaging such as IVUS and optical coherence tomography is necessary in case of diagnostic doubt (especially in SCAD type 2 and 3). The optimal management of SCAD remains unclear. A conservative approach should be the preferred strategy. Conclusion: SCAD should be considered in any young woman presenting with suspicious chest pain with positive troponin. The diagnosis is initially angiographic and may require endocoronary imaging for greater accuracy. Conservative treatment remains the best option.

The carotid diaphragm, an often overlooked cause of stroke by cardiologists.

Carotid diaphragm is a rare cause of stroke. Because of its rarity, it remains often undiagnosed. We report the case of four patients who presented a stroke due to carotid diaphragm. The diagnosis was made either by ultrasound Doppler, computed tomography-angiography or angiography. Two of the four patients were managed by carotid stenting and the other two by surgery. The follow-up was normal. Carotid diaphragm stroke is associated with a high risk of recurrence if not well managed. Therefore, the knowledge of this rare entity is necessary.

An acute lower limb ischemia revealing a covid-19 infection: A case report.

Introduction: Covid-19 is associated with thrombo-embolic events. These complications are either veinous or arterial. By this case report, we aim to highlight the physiopathology and the epidemiology of covid-19 related thromboembolic complications. Case report: We report a case of a 65 years old patient who was admitted fo lower limb ischemia complicating a covid-19 infection. Computed tomography of the aorta and lower limbs showed thrombosis of the femoral artery extended to the popliteal artery and leg arteries. Despite a surgical embolectomy the patient rethromboses twice leading to a thigh amputation. Discussion: Several hypotheses have been put forward to explain Covid 19-related thromboembolic events. About 3% of patients develop arterial thrombosis. Raffaello Bellosta and al. reported the incidence of acute limb ischemia has significantly increased during the COVID-19 pandemic in the Italian Lombardy region. Conclusion: The coagulopathy responsible for venous and arterial thrombosis is a well-established complication of COVID-19. Arterial thromboembolic complications can be either stroke, acute coronary syndrome or peripheral acute ischemia. Therefore, patients with covid19 should be monitored more closely for thromboembolic complications.

[Evaluation of cardiovascular risk factors among the imams of Dakar: about 67 cases]. / Evaluation des facteurs de risque cardio-vasculaire chez les imams: exemple des imams de Dakar (à propos de 67 cas).

The prevalence of cardiovascular risk factors in the general population has been poorly studied in developing countries. The purpose of this study was to evaluate the prevalence of cardiovascular risk factors in a population group in Senegal (the imams). We conducted a cross-sectional and descriptive observational study from April 18th to May 2nd, 2015. Any subject acting as an imam, member of the association of imams and ulamas of Dakar, was included. The study population was quite old, with a mean age of 67.05 ± 12.35 years. The socio-economic level was quite low in the overall population. The prevalence of risk factors was much higher among unpaid imams. The survey revealed a high prevalence of cardiovascular risk factors, with dyslipidemias as a major contributing risk factor observed in 80% of cases. The prevalence of other risk factors was: sedentary lifestyle (74.6%), hypertension (56.7%), diabetes (17%), obesity (10.4%) and metabolic syndrome (19.4%). Risk factor combinations were common and 74.6% of the imams surveyed had at least three cardiovascular risk factors. Global cardiovascular risk was low to moderate in 76.66% of cases, high and very high in 23.33% of cases. This survey showed, on the one hand, a high prevalence of cardiovascular risk factors in imams and, on the other hand, that these risk factors are not often known to subjects. It is imperative to promote studies for the prevention of cardiovascular risk factors.