Cardiovascular emergencies in N'Djamena: Epidemiological, clinical and evolutionary profiles

Abstract

Introduction: Cardiovascular emergencies are a major cause of morbidity and mortality worldwide, with a disproportionate impact in developing countries. The objective of this study was to determine the prevalence of cardiovascular emergencies, to describe different nosologically groups and to specify the evolutionary modalities. Patient and methods: This was a multicenter cross-sectional study conducted over 12 months in the medical emergency and cardiology departments of the Renaissance Teaching Hospital Center and the National Reference Teaching Hospital of N'Djamena. All patients admitted for a cardiovascular emergency during the study period were consecutively included. Results: The overall prevalence of cardiovascular emergencies was 3.2%. The mean age of patients was 54.7 years ± 16.2 years. There was a male predominance (58.3%) with a sex ratio of 1.4 and 78.3% of patients were married. Hypertension was known in 20% of patients and was the predominant cardiovascular risk factor in 59.6% of cases. Stroke (38.7%), acute pulmonary oedema (36.1%) and acute coronary syndromes (10.4%) were the most frequently encountered clinical presentations of cardiovascular emergencies. The most used mode of transportation by our patients for getting to medical emergencies were personal vehicles (35.7%) and city taxis (23.9%). The mean time symptom onset to hospital arrival was 23.6 days ± 17.6 days. The average length of stay was 10.7 days ± 6.2 days. The favorable rate of evolution was 75.2% and the recorded mortality was 18.7%. Conclusion: Prevalence of cardiovascular emergencies is high in our context. The most affected population is young adults. Hypertension plays a major role in this. Stroke is the most common cardiovascular emergencies. Mortality is still high. We need to introduce universal health insurance and develop pre-hospital medicine.