Objective: This work aimed to evaluate the epidemiological clinical aspects and evolutionary aspects of peri partum cardiomyopathy (PPCM) in the cardiology department of the CHU Point G. Materials and Methods: This was a descriptive cross-sectional study from 01 January 2019 to 31 December 2019, including all patients admitted for heart failure during this period. Results: The study involved 40 patients out of 1187 admissions, a hospital prevalence of PPCM was 3.36%. The average age was 26 years plus or minus 7 years with extremes of 16 years and 38 years. The age group between 16 and 20 years was the most represented with 32.5% of cases. Housewives were in the majority with 87.6%; residing in rural areas 62.5%, with a low socio-economic standard of living 32.5% of cases. Multiparous in our context were dominant 42.5%, followed by pauci pares and primiparous with 32.5% and 25% frequency respectively. All our patients, 100% had their first symptom after childbirth, functional signs were dominated by dyspnea of effort present in 100% of patients, followed cough (40%) and chest pain (27.5%). On physical examination there was Tachycardia in 82.5%, Galop B3 (45%) and auscultatory arrhythmia in 5%. Signs of pulmonary condensation (82.5%) and pleural fluid effusion (25%). Hepatomegaly was present in 72.5% of patients. It was overall heart failure in 72.5% of cases. On the electrocardiogram there was sinus tachycardia (75%) and atrial fibrillation arrhythmia (5%). On cardiac Doppler ultrasound the left ventricle was dilated with a low systolic ejection fraction in 100% of patients, the four cavities were dilated in 32.5%, a left intraventricular thrombus in 7.5% of cases and a pericardial fluid effusion in 5% of cases. Biology noted anemia in 22.5% of patients. Treatment was classic for heart failure. The course was punctuated by complications in 42.5% of cases, such as thromboembolic disease (22.5%), ischemic stroke (12.5%), complete arrhythmia by atrial fibrillation (ACFA 5%) and cardiogenic shock (2.5%). Hospital mortality was 7.5% with 67% of deaths observed in the 16-
References
[1]
Pearson, G.D., Veille, J.C. and Rahimtoola, S. (2000) Peripartum Cardiomyopathy. National Heart, Lung, and Blood Institute and Office of Rare Diseases (National Institute of Health). Workshop Recommendations and Review. Journal of the American Medical Association, 283, 1183-1188. https://doi.org/10.1001/jama.283.9.1183
[2]
Bahloul, M., Ahmed, M.N. and Laaroussi, L. (2009) Myocardiopathie du péri partum: Incidence, physiopathologie, manifestations cliniques prise en charge et pronostic. Annales Francaises d’Anesthésie et de Réanimation, 28, 44-60.
https://doi.org/10.1016/j.annfar.2008.11.001
[3]
Letaifa, D.B., Slama, A. and Khemakhem, K. (1999) Cardiomyopathie du péri partum série des cas cliniques. Annales Francaises d’Anesthésie et de Réanimation, 18, 677-682. https://doi.org/10.1016/S0750-7658(99)80156-7
[4]
Ford, L., Abdullahi, A. and Anjorin, F.I. (1998) The Outcome of Peripartum Cardiac Failure in Zaria, Nigeria. Quarterly Journal of Medicine, 91, 93-103.
https://doi.org/10.1093/qjmed/91.2.93
[5]
Cénac, A., Touré, K. and Diarra, M.B. (2004) Sélénium plasmatique cardiomy- opathie du péri partum à Bamako. Medecine Tropicale, 64, 151-154.
[6]
Coulibaly, A. (2001) La cardiomyopathie dilatée du péri partum à propos de 49 cas. Thèse, Med, Bamako, No. 47.
[7]
Diallo, S. (2013) Prise en charge de la CMPP dans le service de cardiologie du CHU du point G: A propos de 49 cas. Thèse, Med, Bamako, No. 37.
[8]
Sliwa, K., Fett, J. and Elkayam, U. (2006) Peripartum Cardiomyopathy. The Lancet, 368, 687-693. https://doi.org/10.1016/S0140-6736(06)69253-2
[9]
Baursache, J., Konig, T. and Vander Meer, P. (2019) Physiopathology, Diagnosis and Management of Peripartum Cardiomyopathy. European Journal of Heart Failure, 21, 827-843. https://doi.org/10.1002/ejhf.1493
[10]
Karaye, K.M., Ishaq, N.A. and S’aidu, H. (2020) Incidence, Clinique, and Risk Factors of Peripartum Cardiomyopathy in Nigeria. ESC Heart Failure, 7, 236-244.
https://doi.org/10.1002/ehf2.12562
[11]
Adjagba (2016) Cardiomyopathie du péri partum au service de cardiologie du CNHU-HKM. Thèse, Med, Cotonou (Bénin), No. 152.
[12]
Diarra, A. (1983) La myocardiopathie du post-partum. (Syndrome de Meadows). Thèse, Med, Bamako, No. 12.
[13]
Ferrier, M., Sacrez, A. and Bouhour, J.B. (1990) La myocardiopathie du péri partum: Aspects actuels. Etude multicentrique: 11 observations. Archives des Maladies du Coeur et des Vaisseaux, 83, 1563-1569.
[14]
Pio, M. (2014) Particularités de la cardiomyopathie du péri partum en Afrique: Le cas du Togo sur une étude prospective de 41 cas au Centre Hospitalier et Universitaire Sylvanus Olympio de Lomé. The Pan African Medical Journal, 17, 245.
https://doi.org/10.11604/pamj.2014.17.245.3058
[15]
Cenac, A., Gaultier, Y., Soumana, I., Toure, I.A. and Develoux, M. (1988) La myocardiopathie post-partum. Evaluation de la réponse clinique et échographique au traitement. 30 cas observés en région soudano sahélienne. La Presse Médicale, 17, 940-944.
[16]
Demakis, J.C., Shaubudin, H. and Rahimtoola, S.H. (1971) Peripartum Cardio- myopathy. Circulation, 44, 964-968. https://doi.org/10.1161/01.CIR.44.5.964
[17]
Lampert, M.B. and Lang, R.M. (1995) Peripartum Cardiomyopathy. American Heart Journal, 130, 860-870. https://doi.org/10.1016/0002-8703(95)90089-6
[18]
Coulibaly, B. (2017) Cardiomyopathie du péri partum dans le service de cardiologie de l’HNF de Ségou: A propos de 70 cas. Thèse, Med, Bamako, No. 65.
[19]
Fett, J.D., Christie, L.G., Carraway, R.D. and Murphy, J.G. (2005) Five-Year Prospective Study of the Incidence and Prognosis of Peripartum Cardiomyopathy at a Single Institution. Mayo Clinic Proceedings, 80, 1602-1606.
https://doi.org/10.4065/80.12.1602