Il s'agit d'une étude observationnelle prospective colligée dans le service des soins intensifs et rythmologie de l'Hôpital militaire d'instruction Mohammed V de Rabat, entre décembre 2008 et décembre 2014, portant sur 424 patients hospitalisés pour insuffisance cardiaque. L’âge moyen était de 60,91±12,77 Les principaux facteurs de risque cardiovasculaires rencontrés étaient: l'hypertension artérielle (46%), le tabagisme (45%), et le diabète (43%). Cliniquement, 63% des patients ont été admis pour insuffisance cardiaque gauche. Le ventricule gauche était dilaté dans 58% des cas, avec une fraction d’éjection moyenne estimée à 36,33±13,5%. L’étiologie dominante était la cardiopathie ischémique (254 cas). En plus d'un traitement médical optimal, 14.4% de nos patients ont fait l'objet d'une resynchronisation cardiaque avec ou sans système de défibrillation. L’évolution intra-hospitalière sous traitement médical était marquée par 26 décès.la durée moyenne d'hospitalisation était de 12,1±6,6 jours.
LVNC should be looked for at any dilated cardiomyopathy particularly in young patients. It requires a careful echocardiographic examination and sometimes CMR to confirm the diagnosis. It is characterized by severe systolic and diastolic dysfunction that would provide poor prognosis.
Our analysis emphasizes increased in-hospital mortality and higher disease severity, over a short period of stay, in heart failure patients with left bundle branch block.
Treatment by All-Trans Retinoic Acid (ATRA) combined with an Anthracycline Chemotherapy has been shown to improve disease-free survival in patients with Acute Promyelocytic Leukemia (APL). Although ATRA is generally well tolerated, occurrence of Retinoic Acid Syndrome (RAS) during the induction chemotherapy in some patients is recognized as a distinct complication and a potential life-threatening side effect.Isolated myocarditis as a result of RAS related to ATRA administration is uncommon and has been rarely reported in the literature.We report a very rare case of ATRA-induced perimyocarditis accompanied by hemodynamic compromise. There was complete resolution of the signs and symptoms of peri-myocarditis when ATRA was temporary suspended. Finally, ATRA was safely resumed.
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