Apport de l’echodoppler cardiaque au diagnostic des endocardites infectieuses a la clinique cardiologique du Chu campus de Lome : A propos de 32 cas

Abstract

Introduction: Infectious endocarditis are serious diseases in africa, in spite of progress of the antibiotherapy and cardiac surgery, especially with the VIH/SIDA pandemia. The diagnostic difficulties are raised by the insufficiency of contribution of hemocultures. Current practices of the transthoracic echocardiography or better of transesophagus echography (T.O.E) are one of the solutions to this diagnostic problem.
Objectives: The aim of this study was to show the contribution of the echocardiography to the diagnosis and the follow-up of infectious endocarditis in a service of cardiology in black Africa. Material and methods: It is about a descriptive retrospective study relating to 32 exploitable files of infectious endocarditis, of African black patients (18 women and 14 men), hospitalized at the cardiology of the Campus teaching hospital of Lome, during 5 years (1st January 2000 to December, 31, 2004). These patients had profited from a clinical examination, 6 hémocultures at least and a transthoracic echocardiography in mode TM, two-dimensional coupled with continuous Doppler, pulsated and color, above all antibiothérapie.

Results: The average age of the patients was 22 years (extrêmes 6 ans and 48 ans). We observed echocardiograhic lesions in 96% of the patients, whereas the hemo culture was positive only in 32% ofthe cases. There were especially valvular vegetations (82%), mutilating lesions 22%. The systolic function of the left ventricle was often normal (88%). The lesions prevailed on the valves of the left heart (79%). The lesions existed on healthy heart in 64,6% of the cases, on the rheumatic valvulopathies in 23%, congenital cardiopathies in 9,3% and prostheses in 3,1% of the case.

Conclusion: The frequency of infectious endocarditis is under estimated in black Africa, because of the
insufficiency of hemocultures. The echocardiography remains very important in the diagnostic approach
of infectious endocarditis. This exam needs to be done currently in our hospitals.