0233 : Profile of patients admitted for hypertensive acute heart failure
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文摘
Acute heart failure AHF is one of the most common situations of hospitalization. The most common cause is myocardial infarction MI. Hypertension or what is called hypertensive heart disease is the second cause. The aim of this work is to study epidemiological, clinical and paraclinical profile of patients admitted for hypertensive AHF.

Methods

This is a retrospective study of 143patients admitted, between January2014 and July2015, for AHF. We excluded patients with hypertensive emergency HE who had hemorrhagic stroke. Diagnosis was held in front of a radio-clinical picture of AHF with SBP>140mmHg at admission.

Results

HE was noted in 36patients or 25.1% admitted for AHF. The mean age was 61+/–11 years with male predominance81%. Two thirds of the patients were not known hypertensive. A third was diabetic, a third chronic smokers, and a third had a history of MI. Clinically, 23 patients with isolated left ventricular failure hypertensive, 8 had an associated unstable angina, 3 had an aortic dissection, and 2 had hypertensive encephalopathy. The mean SBP was 230mmHg, and the mean diastolic 140mmHg. Signs of right heart failure were present in62%. The ECG showed an electric LVH in60% and repolarization disorders in66%. All patients had high filling pressures and diastolic dysfunction grade II in53%. Biologically, the mean serum creatinine was 134mmol/l with an average GFR 50ml/min/ 1.73m2. Renal failure with GFR<30ml/min/1.73m2 was marked in60%. Evolutionarily, we have 3 cases of intra-hospital death, admitted for aortic dissection.

Conclusion

HE is one quarter of patients admitted for AHF. The most common clinical picture is that of an isolated hypertensive left ventricular failure. It occurs mainly in an unknown hypertensive population but characterized by the presence of other risk factors such as diabetes, smoking, and previous history of MI. This syndrome arises in our context a problem of management of comorbidities especially the renal one.

The author hereby declares no conflict of interest

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