TITLE:
Pulmonary Embolism in Young Patients: About 24 Cases at the Cardiology Department of Dakar Principal Hospital in Senegal
AUTHORS:
Joseph Salvador Mingou, Amadou Tidjani Saadou, Madjiguene Ka, Zoumana Sangaré, Serigne Cheikh Tidiane Ndao, Khadidiatou Dia, Mouhamed Cherif Mboup, Pape Diadié Fall
KEYWORDS:
Pulmonary Embolism, Young Patients, Dakar (Senegal)
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.9 No.9,
September
6,
2019
ABSTRACT: Introduction: Pulmonary embolism
is a relatively common life-threatening cardiovascular emergency. It remains a
diagnostic problem because of its nonspecific clinical signs. Objective: The general objective was
to study pulmonary embolism in young patients admitted to the cardiology department
of Dakar Principal Hospital in Senegal. Methodology: This was a
retrospective, descriptive and analytical study in the cardiology department of
the Dakar Principal Hospital over a period of two (02) years from January 1,
2015 to December 31, 2016 in young patients admitted for pulmonary embolism. Results: We collected 24 patients
with a hospital prevalence of 2.18%. The average age was 42.29 years ± 8.41
years with a male predominance (sex ratio of 1.6). The Wells probability score
was low in 54.16% of patients and medium in 45.83%. Functional signs were dominated
by chest pain (83.33% of cases) followed by dyspnea (79.16% of cases). The
thromboembolic risk factors found were gynecological-obstetrical in 16.6% of
cases followed by prolonged bed rest. One case of thrombophilia was present
with a deficiency of protein C and antithrombin III. The electrocardiogram
recorded sinus tachycardia in 29.16% of patients; the Mac Ginn White sign
(S1Q3T3) was found in 25% of cases. Echocardiography
showed pulmonary arterial hypertension in 12.48% of cases, dilation of the
right ventricle and a paradoxical septal motion in 14.28% of cases. CT pulmonary
angiography showed 63.63% of cases with bilateral pulmonary embolism; it was
unilateral in 22.72% of cases. Long-term anticoagulation was based on acenocoumarol
4 mg (66.7%) and Rivaroxaban (33.3%). 62.5% of the patients
were seen at the 3rd month, when a checking was made to evaluate the tolerance
of the treatment, and the evolution of the patient. Conclusion: Pulmonary embolism
is not a rare condition in young subjects but is often underdiagnosed.
Gyneco-obstetrical factors are predominant in this age group. Direct oral
anticoagulants are more and more prescribed in our countries.