Introduction: Peripheral arterial disease of the lower limbs (PAD) is a partial or total obliteration of one or more arteries intended for the lower limbs by atheroma. Its prevalence increases with age, but also with other major cardiovascular risk factors such as diabetes, smoking, high blood pressure and dyslipidemia. Its diagnosis is essentially based on arterial Doppler ultrasound, which studies the topography and extension of the lesions, thus constituting the essential tool for therapeutic decision-making. The objective was to describe the epidemiological and ultrasound profile of patients with atheromatous arterial stenosis of the lower limbs. Methodology: This was a cross-sectional descriptive study running from 1 January 2019 to 31 March 2020, we took a duration of 15 months. This study was carried out at the Conakry University Hospital (Donka and Ignace Deen Hospitals). Results: In our series, the average age was 64.7 ± 13 years, with a sex ratio of 1.04. The average age was 64.7 ± 13 years, with a sex ratio of 1.04. The average age of the women in our series was 64.7 ± 13 years. Risk factors were dominated by advanced age (78.67%), diabetes (58%), hypertension (57%) and physical inactivity (47.66%). Among the 300 patients, 145 were carriers of atheromatous arterial stenosis, or a frequency of 48.33%. The leg arteries were the most affected, followed by the common femoral arteries. Concerning the degree of stenosis, patients with stenosis greater than 70% were the most represented. Conclusion: Peripheral arterial disease of the lower limbs (AOMI) is a pathology not to be neglected in Guinea. Patients have several risk factors : stenosis is an important part of the ultrasound lesions of this disease.

Funding Acknowledgements Type of funding sources: None. Introduction. Takotsubo cardiomyopathy (TTC) mimics an acute coronary syndrome and corresponds to an acute reversible stress-induced cardiomyopathy. Dobutamine Stress Echocardiography (DSE) has been widely used for more than 30 years and is considered as one of the gold standard non-invasive test to detect myocardial ischemia. DSE responsible for a TTC is a rare clinical entity. Purpose. Dobutamine induced takotsubo Cardiomyopathy (TTC-DSE) is an exceptional situation. We systematically search for TTC-DSE observations to analyse the specific characteristics of such a cohort. Methods and Results.  We conducted an extensive search in Medline, and the Cochrane Central Registry of Controlled Trials, using the key words "acute cardiomyopathy, takotsubo syndrome and DSE". File selection was based on the following criteria : (a) occurrence of TTC during DSE, (b) Mayo Clinic criteria (1) associating transient left ventricular systolic dysfunction, absence of significant coronary stenosis, ST-T abnormalities on EKG, moderate troponin elevation, and absence of pheochromocytoma or myocarditis. We identified 30 clinical observations of TTC-DSE published between 2006 and 2019, mostly from USA and Europe publications. Symptoms appear at high dobutamine dosages (30 or 40 gammas/kg/min: 24/30), rarely during recovery (4/30). These patients have the typical features of TTC : (1) strong predominance of a female population (26 women; 86.7%), aged over 50 years (24; 93.3%); (2) depression and/or anxiety (8 pts; 26.7%);  (3) ECG: ST elevation (21 pts; 70 %), ST depression (2 pts), no ST change (4 pts), and left conduction block (3 pts); (4) emergency coronary angiography without significant coronary lesion; (5) angiographic left ventricular ejection fraction (LVEF), calculated in 18/30pts : < 40% for 14/18 pts; (6) segmental LV impairment (echo or angio): apical n = 17 (77.3%); mid-ventricular n = 3 (13.6%); reverse n = 2 (9%) and unspecified (8 pts); (7) low peak of Troponin: 2.65 ± 2.04 ng/ml; (8) one death from an acute heart failure (old lady 86 years age, with intra ventricular gradient), and rapid recovery of LVEF in other patients (29 pts). Despite the heterogeinity in TTC-DSE patients and large cohort of patients in the TTC publications, TTC-DSE and TTC patients have comparable caracteristics. Conclusion. TTC-DSE is an exceptional, but severe complication of DSE. It provides a unique opportunity to observe TTC in the acute phase. These observational studies show a similar profile between TTC-DSE and TTC patients. Mortality remains low in TTC-DSE cohort, probably because of prompt interruption of the test. Rapid recovery of LV function is consistent. High level of sympathetic stimulation secondary to dobutamine infusion, and frequent anxiety associated with DSE, are probably the major determinants of TTC-DSE. However, the rarity of the TTC-DSE, compared to the widespread daily practice of DSE in echo-laboratories, remains unexplained.

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Non-isthmic coarctation of the aorta is a rare congenital malformation in adults. Arterial hypertension is a frequent circumstance of discovery. We reported the case of a 22-year-old Guinean man who had been followed for 5 years for hypertension. Clinically, he presented with hypertension of the upper limbs with a systolic pressure gradient of 100 mmHg. The diagnosis was confirmed by thoracic angioscan, which showed a 65.8% coarctation of the abdominal aorta. He was on triple antihypertensive therapy combining Atenolol 100 mg, Amlodipine 10 mg and Perindopril 10 mg. He is awaiting interventional treatment. His blood pressure is stable at around 140/90 mmHg.

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