Intracardiac masses (ICMs) are often discovered while exploring a stroke, valvular heart disease, during a prolonged fever (infective endocarditis), or incidentally [1] [2] . They include intracardiac thrombi (ICT), cardiac tumors and valvular vegetations [3] . Their diagnosis has been improved by the advent of transthoracic DOPPLER (ETT), transesophageal (ETO) ultrasound and cardiac magnetic resonance imaging (MRI) [4] [5] . In the study by Yao et al. in 2014 [2] , the prevalence of ICMs in the Asian general population was 1.5‰. However, to the best of our knowledge, no global studies on ICMs in Burkina Faso which takes into account all subgroups (intracardiac thrombus, cardiac tumors, valve vegetation) as well as their evolutionary aspects have been carried out. Hence, we propose to look at the epidemiological, clinical, therapeutic and evolutionary aspects of the IMCs while relying on the data collected within the Cardiology department of Dalgado Ouédraogo Teaching Hospital (CHU-YO).

This was a descriptive study retrospectively collected in the cardiology department from January 1, 2011 to March 31, 2013. Any patients regardless of sex, diagnosed and hospitalized for intracardiac masses was included in the study. Each patient included in the study had been followed-up for at least three months. Patients with ICMs other than tumors, thrombi, and valvular vegetations (pacemaker leads, catheters, anatomical remains, valvular calcifications) were excluded from our study. The variables studied included:

Several difficulties were encountered in this prospective study. Indeed, the monocentric nature of the study, the frequent absence of anatomopathological examinations to confirm the nature of the mass, the non-compliance with follow-up appointments, and the difficulty of noting deaths occurring at home were the main constraints of the study.

The limited number of studies or scientific works dealing with thrombi, tumors and valve masses at the same time, and addressing epidemiological, clinical, therapeutic and evolutionary aspects, makes it inappropriate to compare some of our results. Indeed, most studies on ICMs are focused on a specific type of mass, specific diagnostic strategies and treatment methods.

Indeed, the prevalence of intracardiac masses has a hospital frequency of 7.5%. Intracardiac thrombi represent the most frequent group of intracardiac masses, as demonstrated in the literature [5] [6] . In our study, the identified intracardiac tumors accounted for 9.9% of all ICMs recorded, or 0.75% of admissions within the cardiology department. Our results are superior to those of Damourou et al. in Togo, who reported a rate of 0.2% for cardiac tumors in their ICM series [7] . This difference can be explained by the sample size (10 cases against 80 cases). We observed 32 cases of valvular vegetations, representing 39.5% of ICMs studied and 3% of admissions within the cardiology department during the period of our study. Elbey et al. in Turkey noted 89% of vegetations in their series, but their study only concerned patients followed-up for infective endocarditis [8] . In 2010, Ralamboson et al. found a sex ratio of 1.5 in their series of cardiac intracavitary thrombi [9] . Once described as rare in women, the high female prevalence could be explained by the increasingly frequent occurrence of cardiovascular pathologies in women, particularly the ones causing intracardiac thrombi (acute myocardial infarction, dilated cardiomyopathy, valvular diseases).

In our study, ICM was diagnosed when a thromboembolic complication occurred in 18 cases (22.5%), including stroke in 55.6%, pulmonary embolism in 27.8%, syncope in 11.1% and acute ischemia of the lower limb in 5.6%. Thomas C et al. reported 5.2% of strokes during a 31-month follow-up period in patients treated for left intraventricular thrombi [10] . Our higher value could be explained by the fact that our study was carried out in a national referral hospital, which often receives immediately complicated cases of ICTs transferred from peripheral health facilities.

In our study, thrombus left intraventricular localization was found in 65.8% of ICT cases. This result is in line with those of Stefano and Davinder, who reported that left intraventricular thrombosis was the most frequent type of ICT, occurring most frequently in heart disease with LV dilatation and in cases of impaired LV systolic function (dilated cardiomyopathy, acute myocardial infarction) [11] [12] . In the literature, left atrial thrombosis is favored by atrial fibrillation and mitral valve disease [3] [13] . They accounted for 29.3% of ICT cases, of which 66.7% of patients had valvulopathy and 41.7% had atrial fibrillation in our series.

The location of the vegetations was predominantly mitral (23.8% of cases) and aortic (17.5% of cases). A predominance of mitral location was reported by Elbey et al. in Turkey (mitral in 43.1% of cases, aortic in 39.1% and tricuspid in 8.9%). The difference in the population size presenting valvular mass during endocarditis could explain the discrepancies in our rates [8] .

Therapeutically, except in cases where surgery is indicated, the treatment of intracardiac thrombosis relied on the use of anticoagulants. In the literature, the choice of treatment is sometimes debated, ranging from thrombolysis to thrombectomy. In our study, anticoagulant treatment with low-molecular-weight heparin (LMWH) was initiated in 100% of patients. In 97.6% of cases, LMWH was used in conjunction with AVK. For some authors, the benefit of thrombectomy is comparable to anticoagulation in the case of ICT [14] . Intracardiac thrombosis accounted for 19.5% out of the 18.5% mortality rate for ICM. In-hospital and out-of-hospital mortality in intracardiac tumors was 37.5% and 40% respectively, reflecting their severity. Indeed, most authors agree that surgical removal remains the only therapeutic modality for benign cardiac tumors (myxoma and fibroelastoma) [15] - [17] . However, only symptomatic treatment was used in our patients, which would justify the very high mortality rate.

Intracardiac masses visualized on ultrasound are most often due to thrombi, vegetations or myxomas. However, many other benign or malignant tumors are also present. In our study, intracardiac thrombosis was the most frequent mass, accounting for 50.6% of cases. Intracardiac masses are serious because of their high mortality rate (intra-hospital and post-hospital) estimated at 33.7%. Their late diagnosis is a potential source of poor prognosis. They therefore require prolonged monitoring to preserve the patient’s survival. A prospective study on a larger sample deserves to be carried out in order to gather significant data that is likely to help establish a management protocol adapted to our context.