[Cardiothyreosis: retrospective study of 32 cases in the cardiology and internal medicine department at Ouagadougou, Burkina Faso (1993-1998)]

Abstract

Cardiothyreosis is a relatively frequent condition in Sub-Saharan Africa and represents 1.7% of cardiac admissions in Ouagadougou. In this retrospective study, our aim has been to describe clinical characteristics of the disease and its cross-disciplinary management. Over a period of six years (1993-1998), we observed 32 cases of cardiothyreosis at the Centre Hospitalier Yalgado Ouedraogo. Average age was 43.3 +/- 14.7, with a clear majority of women (78.1%). Systolic blood pressure was on average 136 +/- 5 mmHg and mean diastolic blood pressure was 78 +/- 16 mmHg. Mean heart frequency was measured at 125 +/- 27 beats/minute and we detected 13 cases (41%) of atrial fibrillation. Heart failure occurred in 22 cases (69%). Underlying mitral valvulopathy was found in 5 cases. Arrhythmia was reduced in 53% of the cases, after treating with betablocker or cibenzoline (4 cases). Eighteen out of 25 patients presented anaemia (72%), 64% had hypocalcemia, and 50%--hypokaliemia. The average cardio-thoracic index was 0.63 +/- 0.09 with extremes of 0.75 and 0.40. An echocardiogramme was conducted for 10 patients and showed atrial dilation in 4 cases and ventricular dilation in one case. This turned out to be Basedow illness in 62.5% of the cases and multinodular goitre in 37.5%. Mean hospitalisation was 18.3 +/- 12.7 days. Antithyroidian treatment led to a positive evolution in 97% of the cases (only one death occurred through refractory heart failure).