A 32 year-old patient has a bi-ventricular insufficiency that had developed over the past 2 months revealed by cardiac symptomatology. Echocardiography revealed bi-ventricular dilated cardiomyopathy. He had skin lesions for three years that were clinically and histologically identified as psoriasis. The association of cardiomyopathy with psoriasis is rare and intriguing and the link between these two entities on a common inflammatory background is discussed.

Introduction: Sudden death is most often due to severe arrhythmias such as ventricular fibrillation which are responsible for 25% of deaths. This is the first cause of death in the chronic hemodialyzed patient. Purpose: To study electrocardiographic disorders and metabolic abnormalities in chronic hemodialyzed patient before , during and after the hemodialysis session. Materials and Methods: This is a descriptive, prospective and analytical study carried out in collaboration with the Department of Cardiology and Nephrology of the University Hospital of Marrakech, over a period of 6 months including 56 chronic hemodialyzed patients who received a 24-hours electrocardiogram (EKG) and a biological checkup before and after their hemodialysis session. Results: The average age of our patients was 49.89 years with extremes ranging from 16 to 86 years. Female predominance was noted (51.78%) with an M/F sex ratio of 0.9. Causal nephropathy is undetermined in 44.6% of cases. Vascular initiation was by venous arterial fistula in 98.2% of cases. Sinus tachycardia was objectified in 9% of cases during dialysis and 7% after the session. The duration of the corrected QT was an average of 441ms, 445ms and 430ms before and after hemodialysis respectively with a statistically significant decrease. Isolated ventricular extrasystoles were objectified in 23.2% of the cases before, 26.8% of the cases during and 48.2% of the cases after the hemodialysis session. Hyperkalemia was noted in 82.1% of cases in before dialysis and hypercalcemia in 16.1% of cases after dialysis. Conclusion: Metabolic variations during dialysis can lead to a significant risk of cardiac arrhythmias. Chronic hemodialysis should therefore benefit from regular monitoring of electrolytes and cardiovascular status to reduce morbi-mortality on dialysis.

No abstract