RESUMEN
Thyrotoxicosis is underdiagnosed because of its low occurrence in series from Africa. The aim of this study was to evaluate the frequency, the demographic data, and the etiological aspects of thyrotoxicosis among hyperthyroidy. Thirty-six patients with thyrotoxicosis (group I) gathered during a period of four years was analysed, as well as 180 hyperthyroidy cases (group II). Cardiothyrotoxicosis was observed with a frequency of 16.6%. The mean age was respectively of 44.5+/-13.3 versus 32.8+/-11.4 years (p<10(-6)). Cardiothyrotoxicosis was related to multinodular goitres (18 cases), a Basedow disease (14 cases), a toxic adenoma (four cases), while the principal cause of hyperthyroidy was toxic adenoma followed by the Basedow disease (72 cases, 40%). Different modes of presentation of cardiothyrotoxicosis were found: cardiac heart failure in 27 cases (75%), permanent atrial fibrillation in 22 cases (61.1%), atrial flutter in two cases, coronary insufficiency in four cases, ventricular extrasystoli (trigeminism) in two cases, second auriculoventricular block in two cases, dilated myocardiopathy in 10 cases (27.7%), ischemic myocardiopathy in four cases, severe mitral regurgitation in one case. This study confirms the relative frequency of cardiothyrotoxicosis, the proportionally weak place of Basedow disease among hyperthyroidy's causes, and role of associated cardiac disease to the hyperthyroid.
Asunto(s)
Cardiopatías/complicaciones , Tirotoxicosis/complicaciones , Adulto , Anciano , Estudios Transversales , Femenino , Cardiopatías/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Marruecos , Tirotoxicosis/epidemiología , Adulto JovenRESUMEN
BACKGROUND: There is evidence that the human immunodeficiency virus (HIV) may affect the heart and left ventricular dysfunction appears to be common. OBJECTIVE: This was the first study in Morocco to investigate the frequency of cardiomyopathy in patients infected with HIV. METHODS: We made a prospective echocardiographic study of 158 patients starting in September 2004 (88 men and 70 women, mean age 34 [5.4] years) with positive HIV serology and a clinical diagnosis of HIV infection according to CDC criteria and 80 seronegative control subjects. Patients were classified as AIDS group (90 patients) and HIV group (+) (68 patients) and HIV (-) (80 subjects). RESULTS: Twenty-eight out of 156 (17.7%) cases of cardiomyopathy were found, distributed in 24 out of 90 (26.6%) in the AIDS group and four out of 68 (2.8%) in the HIV+group (p<0.01) and none in the HIV (-) group. Left ventricular diastolic dysfunction was noted among 88 out of 158 (55.7%) infected patients. There was a significant increase of cardiomyopathy in patients with HIV infection and decreased CD4 (less than 100 per millimetre cube; n=16 [57%]) compared to those with CD4 between 100 and 200 per millimetre cube; n=6 (21.42%) (p=0.03). CONCLUSION: Echocardiography was a useful technique for the early detection of cardiac dysfunction in asymptomatic HIV positive carriers and AIDS patients. The frequency is related to HIV infection stage and CD4+ counts. Left ventricular diastolic dysfunction can precede systolic dysfunction and may be a useful technique for the early detection of cardiac dysfunction.
Asunto(s)
Cardiomiopatías/epidemiología , Cardiomiopatías/etiología , Infecciones por VIH/complicaciones , Adulto , Cardiomiopatías/diagnóstico por imagen , Ecocardiografía , Femenino , Homosexualidad/estadística & datos numéricos , Humanos , Masculino , Prevalencia , Estudios Prospectivos , Razón de Masculinidad , Conducta SexualRESUMEN
Authors report 10 observations of cardiac hydatid cyst collected to cardiovascular unit of Ibn Rochd hospital in Casablanca during last 7 years. Clinical investigation included in all cases chest X ray, ECG and ultrasonography (US). A computed tomography (CT) scan was performed in 6 cases, magnetic resonance imaging in four cases, transoesophageal US in two cases. Examination for other hydatic sites was realized in all cases, and brain CT was performed in 5 cases. The hydatid cyst was variably localized in the left ventricle in 6 cases, the pericardium in 4 cases, the interventricular septum in 2 cases, the right auricle in 2 cases and multiple locations in one case. The existence of other cardiac hydatid sites was found in 7 cases. Seven patients have been operated (2 cases to closed heart). Outcome was favorable in 6 cases with a mean of three years survey. Two patients died and 2 others have been lost of view. The diagnosis of the cardiac hydatid cyst has benefits from the combination USCT scan that allowed a precise topographical inventory, reducing the need for MRI to the complicated cases and to the rare cases of inconclusive results by US-CT scan.
Asunto(s)
Equinococosis/diagnóstico , Cardiopatías/parasitología , Adolescente , Adulto , Niño , Diagnóstico por Imagen , Equinococosis/terapia , Femenino , Cardiopatías/terapia , Humanos , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
The authors report the clinical history of a 22-year-old woman, followed for Behçet's disease, who presented a prolonged fever for two months associated with oral and genital ulcerations. There was an inflammatory syndrome, papillary oedema without brain injury. Echocardiography revealed moderate pericardial effusion and voluminous thrombosis of right atria and right ventricle. Chest computed tomography showed a lung infarction without thrombosis of pulmonary artery. The antiphospholipid antibodies were negatives. The treatment was based on corticotherapy and anticoagulation with a good outcome. In Behçet disease, cardiac involvement manifestations as pericardial, myocardial or endocardial lesions. This case underlines the rarity of cardiac thrombosis in Behçet disease.