Acute Circulatory Failure in Cardiology: Epidemiological, Etiological, Therapeutic, and Prognostic Aspects of 150 Cases in Dakar, Senegal

Introduction: Acute circulatory failure is a major clinical syndrome resulting from the heart’s inability to pump enough blood to meet the body’s metabolic needs. It is a real public health issue. The aims of the study were to determine the prevalence of acute circulatory failure; to describe the etiological, therapeutic, and prognostic aspects; and to analyse prognostic factors in a cardiological setting in Dakar, Senegal. Methodology: This was a multicentric, cross-sectional, descriptive, and analytical study conducted from 1st October 2019 to 30th June 2020. Included were patients aged at least 18 years, hospitalised in cardiology departments in Dakar, Senegal, for the acute circulatory failure of all etiologies. We studied socio-demographic aspects, clinical and paraclinical data, stratified patients’ prognostic risk, and adapted therapeutic modalities and monitoring. Data analysis was performed using SPSS software version 24.0. Any difference less than 0.05 was considered statistically significant. Results: The study enrolled data from 150 patients hospitalised for acute circulatory failure, representing 8.69% of cardiology admissions. Among them, 24.75% presented with cardiovascular collapse and 75.25% with shock. The average age was 53 years with a range from 17 to 83 years, and a female predominance with a sex ratio of 0.78. The main risk factors included age (50.5%), sedentariness (41.6%), and high blood pressure (34.7%). About a fifth of the patients had a history of dilated cardiomyopathy. Echocardiography revealed dilation of cardiac chambers (34.7%) and elevated ventricular filling pressures (43.6%). The origin of the failure was mainly cardiogenic (48.67%). Hospital mortality reached 38.61%, with the majority of deaths occurring within the first 15 days. Heart failure was correlated with the emergence of acute circulatory failure (p = 0.014), while septic shock was associated with increased mortality in cases of acute circulatory failure (p = 0.03). Conclusion: This research highlights, in a cardiological setting, the various aspects of acute circulatory failure, identified as a predominant pathology among cardiovascular disorders, associated with a high mortality rate, underlining the urgency of rapid and effective intervention in an intensive care unit.Subject AreasCardiology