Prognostic Factors Associated with Aortic Dissection at the Cardiac Intensive Care Unit of the Point “G” Hospital University Center, Bamako, Mali
2019
Objective: The purpose of this study was to describe the prognostic factors
associated with aortic dissection with the cardiology intensive care unit of
the Point “G” Hospital University Center. Methodology: This was a descriptive
transversal study from January 2010 to February 2017 that included all
inpatients during this period. Results: Of 6912 patients
admitted, 23 patients were admitted for an
aortic dissection, a frequency of 0.33%. Of these, (6) six were under
age 50 (26.1%) and the majority age group was 50 - 69 years old.
Cardiovascular risk factors were high blood pressure, smoking, and diabetes
with 73.9%, 60% and 13% of cases, respectively. At the clinic, chest pain and
dyspnea were the main symptoms with respectively 65.2% and 52.2% and with 56.5%
asphygmy was associated with pain.
Para-clinically, renal failure and anemia
were the major laboratory abnormalities found with respectively 43.75% and
31.25% of cases. Doppler echocardiography revealed lesions associated with
aortic dissection. In the thoracic angioscan,
the aortic dissection was type A (43.5%) and 56.5% type B. The co-morbidities,
the associated lesions and the hemodynamic state of the patient indicate the
degree of urgency. The treatment was medical. The evolution was full of
complications with 52.2% of deaths including 7 (seven) type A patients.
Intra-hospital death was 26.1%. Other complications were heart failure (47.8%),
the renal failure (43.75%) and an aortic
aneurysm (34.8%). Conclusion: Aortic dissection is
a life-threatening medical and surgical emergency.
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