Introduction: The location of the conduction pathways and their intimate anatomical relationship with the aortic valve provide insight into the occurrence of arrhythmias and conduction disorders during aortic stenosis. These disorders have an important prognostic impact. our work proposes to determine and describe the rhythm and conduction disorders encountered in aortic stenosis in a Moroccan population group while recalling the causes and the prognostic and therapeutic impacts of this association. Materials and methods: This is a retrospective study of 148 patients with aortic stenosis hospitalized at the cardiology center of the HMIMV over a period of 24 months during which we analyzed the clinical and electrocardiographic data in order to describe and analyze the rhythm and conduction disorders encountered in this pathology. Statistical analysis was performed with SPSS software, version 18. Results: The mean age of the population was 65 (57, 74) years, the sex ratio was 1.21 with male predominance. Smoking (current or former) reported in 38.5% of patients was the main modifiable cardiovascular risk factor, followed by hypertension in 35.8% of patients. Dyspnea of effort was the most frequent reason for consultation at 81% of which 64% (of these) were at least of the functional class III of the NYHA. Palpitations and lipothymia or syncope accounted for 21% and 16.2% of the series. The aortic stenosis was tight overall with a mean aortic area of 0.8 [O, 6; 1] cm². Aortic stenosis was rarely isolated. In 36% of cases, it was associated with rhythm and conduction disorders. Among these disorders, atrial fibrillation was the most frequent (36.5%), followed by left anterior hemiblock (17%), LBBB (13.5%) and RBBB (9.5%). Finally there was 9.4% of complete atrioventricular block. Conclusion: The occurrence of arrhythmias and conduction disorders during aortic stenosis is frequent and due to multifactorial mechanism. In the literature, their prevalence is variable ......
Introduction: The risk factors for aortic stenosis have been shown to be similar to those for atherosclerosis. Thus, coronary disease is often found simultaneously in patients with aortic stenosis. Our work aims to determine the frequency of coronary disease in a Moroccan population with aortic stenosis while recalling the causes and the prognostic and therapeutic impacts of this association. Materials and Methods: This is a retrospective study of 148 patients hospitalized at the cardiology center of the military hospital of Rabat over a period of 24 months, during which we analyzed clinical, electrocardiographic, echocardiographic and coronarographic data of the patients in order to evaluate the coronary involvement during aortic stenosis. Results: The mean age of the population was 65 [57, 74] years, the sex ratio was 1.21. Smoking reported in 38.5% of patients was the main modifiable cardiovascular risk factor, followed by hypertension in 35.8% of patients. Dyspnea on exertion was the most frequent reason for consultation at 81%, 64% of which were at least NYHA functional class III, followed by angina, which represented 33% of the series. The aortic stenosis was tight in the majority (mean SAo: 0.8 cm²) and the left ventricular ejection fraction was preserved overall. Coronary artery disease was associated with aortic stenosis in 24% of cases, with predominantly monotruncal involvement (53%) followed by tritruncal involvement (30%). 21.6% of these patients underwent coronary artery bypass grafting concomitantly with surgical replacement of the aortic valve. Conclusion: The incidence of coronary artery disease associated with aortic stenosis is variable according to age. It is higher in European series because of aging. In our relatively younger population, it is lower but not negligible.
COVID-19-related hypercoagulability state resulting in thromboembolic events is widely described in critically ill patients, especially in those hospitalized in the intensive care unit. Nevertheless, these thrombotic events are uncommon in COVID-19-patients with mild disease. Herein we present the case of a 51-year-old male admitted for pulmonary embolism who previously presented a mild COVID-19 twenty days earlier. He was discharged on Rivaroxaban. This finding raises discussion about extending prophylactic anticoagulation in selected patients with mild COVID-19 at a high risk of VTE.
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