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खुला एक्सेस

अमूर्त

Syncope in Cardiological Department: The First Multicenter Study in Dakar (Senegal)

Guindo A*, Aw F, Adama K, Sarr SA, Diouf Y, Mingou JS, Tabane A, Beye SM, Diop CMBM, Diop KR, Diallo S, Akanni S, Diouf MT, Bodian M1 , Ngaidé AA, Dioum M, Affangla A, Leye MCBO, Mbaye A, Ndiaye MB, Kane A, Diao M

Introduction: Syncope represents 1 to 6% of hospitalizations in the emergency department. Syncope is classified as reflex, orthostatic hypotensive, or cardiac. The initial assessment allows beyond diagnosis to define the severity of the picture related to the underlying disease rather than to the syncopal event itself. Our study represents the first study in Senegal on the assessment of syncope.

Methodology: This was a descriptive cross-sectional study over a period from May 1, 2020 to July 30, 2021 that included all patients received for syncope, whether hospitalized or not in the cardiology departments of Aristide Le Dantec (HALD), Principal hospital and Idrissa Pouye hospital (HOGIP).

Results: We collected 86 patients including 73.25% in HALD, 15.2% in HOGIP and 11.68% in Principal. The mean age was 61.6 years with a standard deviation of 20.11 predominantly male or 54.7%. Of the patients 65.1% were hospitalized and 34.9% were not. The most common cardiovascular risk factors were hypertension (48.84%) and diabetes (12.8%). The majority of patients had duration of syncope of less than 7 days (55.62%). The ECG found a predominance of full BAV 58.13%, as did the Holter ECG (23.07%). The implantable Holter ECG found in one patient a symptomatic sinus pause of 3 sec. The responses to the tilt test were mixed in 57.14%, cardioinhibitory without asystole in 7.14% late orthostatic hypotension in 7.14% of cases, vasodepressive in 28.57% of cases. Cardiac ultrasound found systolic LV dysfunction (5%), moderately severe aortic stenosis (1.25%) and intracavitary thrombi (2.5%). Cardiac syncope was mostly found (67.44%), followed by reflex syncope (16.27%), and syncope by orthostatic hypotension (1.16%). All patients with reflex syncope and orthostatic hypotension followed the hygieno-dietetic measures. All patients with severe conductive disorders received a pace maker (57.69%).

Conclusion: Syncope is a functional sign whose diagnostic and therapeutic approaches are varied, ranging from a simple disabling reflex syncope but with a good prognosis to cardiac syncope likely to be life-threatening requiring rapid and optimal management. Unraveling the banal from the dramatic in the face of syncope is a heavy task for the cardiologist.