Cardiology and Cardiovascular Research

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Acute Coronary Syndrome in Patient with Viral Hepatitis C: An Underdiagnosed Condition in Sub-Saharan Africa

Received: 09 February 2019    Accepted: 11 March 2019    Published: 26 March 2019
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Abstract

Viral hepatitis C (VHC) infection is associated with many systemic diseases. Amongst these, the association with ischemic heart disease is underdiagnosed in Sub-Saharan Africa context. We present a case of acute coronary syndrome in a Cameroonian patient with viral hepatitis C with low cardiovascular risk. A 75 years old female followed up for hepatocellular carcinoma secondary to VHC cirrhosis. She was admitted in the hospital for a sudden, resting, intense constrictive thoracic pain lasting more than one hour. This patient initially consulted the gastroenterologist, but secondarily the cardiologist 24 hours after the previous consultation. The initial workup showed ST segment elevation in lead V1 to V4 with Q Wave in the same territory and elevated value of Troponin Ius and CPKMB. Cardiac ultrasonography found akinesia in the anteroseptal and apical segments. Other biological exams showed a dyslipidemia without other cardiovascular risk factors. Despite poor financial resources, the patient was managed with Enoxaparine 8000 UI/12H, Clopidogrel 75mg/24H, Aspirine 100mg/24h. Rosuvastatine 10Mg/24h, Ramipril 2,5mg/24h and Nebivolol 2.5mg/24h, tramadol 100mg/8h, trimetazidine 35mg/12h, omeprazole 40mg/24h, molsidomine 1mg/8h. The pain disappeared 24hours after the beginning of the treatment. In sub-Saharan Africa with high burden of viral hepatitis C infection, we should consider this possibility in patients who present ischemic heart disease with lowcardiovascular risk.

DOI 10.11648/j.ccr.20190301.15
Published in Cardiology and Cardiovascular Research (Volume 3, Issue 1, March 2019)
Page(s) 18-21
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Acute Coronary Syndrome, Viral Hepatitis C, Sub-Saharan Africa

References
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[4] Libby P, Theroux p. pathophysiology of coronaryartery disease. AHA. 2005; 111: 3481-3488.
[5] Obama Shoeib, Medhat Ashmawy et al. Association between coronary artery disease and hepatitis C virus seropositivity. EMHJ- vol. 24 N. 7-2018.
[6] A. Gilbert and G. Lion, “Arterites infectieuses experimentales,” C R Hebd Seances Soc Biol Fil, vol. 41, pp. 583–584, 1889.
[7] J. Bigna, Marie Amougou et al. seroprevalence of hepatitis C virus infection in Cameroon: a systematic review and meta-analysis. BMJ. Vol. 7, no 8.2017.
[8] Salvatore Petta. Hepatitis C and cardiovascular: A review. Journal of Advanced Research (2017) 8, 161–16.
[9] R. Zampino, A. Marrone, L. Restivo et al., “Chronic HCV infection and inflammation: clinical impact on hepatic and extrahepatic manifestations,” World Journal of Hepatology, vol. 5, no. 10, pp. 528–540, 2013.
[10] N. Ishizaka, Y. Ishizaka, E. Takahashi et al., “Association between hepatitis C virus seropositivity, carotid-artery plaque and intima-media thickening,” The Lancet, vol. 359, no. 9301, pp. 133–135, 2002.
[11] Marwan S. Abougergi, Raffi Karagozian et al. ST Elevation Myocardial Infarction Mortality Among Patients With Liver Cirrhosis: A Nationwide Analysis Across a Decade. J Clin Gastroenterol, Vol. 49, no. 9, pp. 778-782, 2015.
[12] Petta S., Torres D. et al. Carotid athererosclerosis and chronic hepatitis C: a prospective study of risk associations; hepatology. 2012; 55: 1317-1323. (PubMed).
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Author Information
  • Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon

  • Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon

  • Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon

  • Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon

  • Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon

  • Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon

  • Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon

  • Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon

  • Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon

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  • APA Style

    Helles Murielle Lema, Mazou Ngou Temgoua, Ngam Mary Engonwei, Mounpou Blaise, Tonleu Carole, et al. (2019). Acute Coronary Syndrome in Patient with Viral Hepatitis C: An Underdiagnosed Condition in Sub-Saharan Africa. Cardiology and Cardiovascular Research, 3(1), 18-21. https://doi.org/10.11648/j.ccr.20190301.15

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    ACS Style

    Helles Murielle Lema; Mazou Ngou Temgoua; Ngam Mary Engonwei; Mounpou Blaise; Tonleu Carole, et al. Acute Coronary Syndrome in Patient with Viral Hepatitis C: An Underdiagnosed Condition in Sub-Saharan Africa. Cardiol. Cardiovasc. Res. 2019, 3(1), 18-21. doi: 10.11648/j.ccr.20190301.15

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    AMA Style

    Helles Murielle Lema, Mazou Ngou Temgoua, Ngam Mary Engonwei, Mounpou Blaise, Tonleu Carole, et al. Acute Coronary Syndrome in Patient with Viral Hepatitis C: An Underdiagnosed Condition in Sub-Saharan Africa. Cardiol Cardiovasc Res. 2019;3(1):18-21. doi: 10.11648/j.ccr.20190301.15

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  • @article{10.11648/j.ccr.20190301.15,
      author = {Helles Murielle Lema and Mazou Ngou Temgoua and Ngam Mary Engonwei and Mounpou Blaise and Tonleu Carole and Mefire Aicha and Ahinaga Andre Jules and Boombhi Jerome and Menanga Alain},
      title = {Acute Coronary Syndrome in Patient with Viral Hepatitis C: An Underdiagnosed Condition in Sub-Saharan Africa},
      journal = {Cardiology and Cardiovascular Research},
      volume = {3},
      number = {1},
      pages = {18-21},
      doi = {10.11648/j.ccr.20190301.15},
      url = {https://doi.org/10.11648/j.ccr.20190301.15},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ccr.20190301.15},
      abstract = {Viral hepatitis C (VHC) infection is associated with many systemic diseases. Amongst these, the association with ischemic heart disease is underdiagnosed in Sub-Saharan Africa context. We present a case of acute coronary syndrome in a Cameroonian patient with viral hepatitis C with low cardiovascular risk. A 75 years old female followed up for hepatocellular carcinoma secondary to VHC cirrhosis. She was admitted in the hospital for a sudden, resting, intense constrictive thoracic pain lasting more than one hour. This patient initially consulted the gastroenterologist, but secondarily the cardiologist 24 hours after the previous consultation. The initial workup showed ST segment elevation in lead V1 to V4 with Q Wave in the same territory and elevated value of Troponin Ius and CPKMB. Cardiac ultrasonography found akinesia in the anteroseptal and apical segments. Other biological exams showed a dyslipidemia without other cardiovascular risk factors. Despite poor financial resources, the patient was managed with Enoxaparine 8000 UI/12H, Clopidogrel 75mg/24H, Aspirine 100mg/24h. Rosuvastatine 10Mg/24h, Ramipril 2,5mg/24h and Nebivolol 2.5mg/24h, tramadol 100mg/8h, trimetazidine 35mg/12h, omeprazole 40mg/24h, molsidomine 1mg/8h. The pain disappeared 24hours after the beginning of the treatment. In sub-Saharan Africa with high burden of viral hepatitis C infection, we should consider this possibility in patients who present ischemic heart disease with lowcardiovascular risk.},
     year = {2019}
    }
    

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    T1  - Acute Coronary Syndrome in Patient with Viral Hepatitis C: An Underdiagnosed Condition in Sub-Saharan Africa
    AU  - Helles Murielle Lema
    AU  - Mazou Ngou Temgoua
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    AU  - Mounpou Blaise
    AU  - Tonleu Carole
    AU  - Mefire Aicha
    AU  - Ahinaga Andre Jules
    AU  - Boombhi Jerome
    AU  - Menanga Alain
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    JO  - Cardiology and Cardiovascular Research
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    PB  - Science Publishing Group
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    AB  - Viral hepatitis C (VHC) infection is associated with many systemic diseases. Amongst these, the association with ischemic heart disease is underdiagnosed in Sub-Saharan Africa context. We present a case of acute coronary syndrome in a Cameroonian patient with viral hepatitis C with low cardiovascular risk. A 75 years old female followed up for hepatocellular carcinoma secondary to VHC cirrhosis. She was admitted in the hospital for a sudden, resting, intense constrictive thoracic pain lasting more than one hour. This patient initially consulted the gastroenterologist, but secondarily the cardiologist 24 hours after the previous consultation. The initial workup showed ST segment elevation in lead V1 to V4 with Q Wave in the same territory and elevated value of Troponin Ius and CPKMB. Cardiac ultrasonography found akinesia in the anteroseptal and apical segments. Other biological exams showed a dyslipidemia without other cardiovascular risk factors. Despite poor financial resources, the patient was managed with Enoxaparine 8000 UI/12H, Clopidogrel 75mg/24H, Aspirine 100mg/24h. Rosuvastatine 10Mg/24h, Ramipril 2,5mg/24h and Nebivolol 2.5mg/24h, tramadol 100mg/8h, trimetazidine 35mg/12h, omeprazole 40mg/24h, molsidomine 1mg/8h. The pain disappeared 24hours after the beginning of the treatment. In sub-Saharan Africa with high burden of viral hepatitis C infection, we should consider this possibility in patients who present ischemic heart disease with lowcardiovascular risk.
    VL  - 3
    IS  - 1
    ER  - 

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