Introduction: Cardiovascular emergencies represent a major public health challenge in sub-Saharan Africa, with high morbidity and mortality. Their profile in intensive care in Gabon is poorly documented. The objective of this work was to describe the epidemiological, clinical, and evolutionary aspects of cardiovascular emergencies at Owendo University Hospital Center (CHUO). Methods: This was a retrospective cohort study conducted in the intensive care unit of CHUO from January 1, 2021, to December 31, 2024. All adult patients admitted for a cardiovascular emergency were included. Demographic, clinical, diagnostic, and evolutionary data were analyzed. Logistic regression was performed to identify factors associated with mortality. The significance threshold was set at p < 0.05. Results: Among 1334 admissions, 311 patients (23.3%) presented with a cardiovascular emergency. The mean age was 34.8 ± 14.2 years. The sex ratio was 0.15. Hypertension (22.5%) and overweight/obesity (27.7%) were the main risk factors observed. Hypertensive emergencies accounted for 76.2% of cases, primarily in obstetric contexts. Other cardiovascular emergencies encountered included strokes (15.4%), acute heart failure (5.4%), pulmonary embolism (1.9%), aortic dissection (0.3%), and pericardial tamponade (0.3%). Hospital mortality was 9%. In univariate analysis, hemorrhagic stroke was strongly associated with mortality (OR = 15.76; 95% CI [6.7 - 37.4]; p < 0.001). In multivariate analysis, no variable remained significantly associated, although a trend was observed for hypertension. Conclusion: Cardiovascular emergencies in intensive care at CHUO are dominated by obstetric hypertensive conditions. Hemorrhagic stroke is the main factor of mortality. Strengthening hypertension prevention and improving technical facilities are necessary.
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