Mohammad El Tahlawi

and 4 more

Background: Congenital pulmonary stenosis (PS) is a progressive disease. Balloon pulmonary valvuloplasty (BPV) is the treatment of choice in valvular PS. Aim: We aim to study the relationship between biomarkers and echocardiographic markers in valvular PS and to assess the impact of BPV on these markers. Patients & Methods Patients with moderate and severe valvular PS amenable for BPV were recruited. Serum troponin I was measured. Echocardiographic assessment of PS and right ventricular (RV)function were done. All patients underwent BPV. Troponin level and echocardiographic data were re-assessed two weeks & six months after BPV. Results: Fifty patients with valvular PS were recruited. There was significant correlation between peak SPG and troponin (p < 0.001). Troponin was significantly decreased 2 weeks after BPV. Similarly, there was an initial improvement in RV function. After 6 months of follow up, we divided patients into 2 groups: Group-A: 36 patients with no restenosis. Group-B: 14 patients with restenosis. There were high significant differences between both groups regarding troponin level and RV functions with re-elevated troponin in group-B that correlated with peak PG (r= 0.9, p < 0.001). RV function parameters in group-B became significantly worse 6 months after BPV than those after the initial 2 weeks. Conclusion Troponin correlates with the severity of PS and associates with RV dysfunction. Both troponin & RV functions improved with BPV. Recurrent elevation of troponin and impairment of RV function are associated with PV restenosis and could be set as an indication for repeated balloon dilatation of PV.

Mohammad El Tahlawi

and 7 more

Background: PCR used for SARS‐CoV‐2 diagnosis is variable and unstable. Lung ultrasound has good safety and accuracy in pneumonia. We aim to evaluate the ability of bedside lung ultrasound in suspecting the diagnosis and/or predicting the prognosis of Covid 19 infection. Patients & Methods: We recruited any case with pulmonary symptoms necessitating admission in intermediate care and/or ICU during the period between 27th March and 11th April 2020 in 3 international centres. Patients were stratified according to Covid 19 PCR results. All patients underwent chest X ray, CT, lung ultrasound, echocardiography and laboratory analysis. Results: Eighty-two cases were recruited. Fifty cases (61%) were negative for SARS‐CoV‐2 while 32 cases (39%) were positive. Sixty-four cases (78%) were recovered while 18 cases (22%) died. Covid 19 patients had more A profile and more abnormal A lines than non-Covid 19 group (p<0.001). Smoking, congestion in X ray, A profile and abnormal A lines in lung ULS are independent predictors for Covid 19 infection. A scoring system for prediction of Covid 19 using clinical and radiological data was calculated with a sensitivity of 93.8% and a specificity of 58%. Mortality in Covid 19 patients is significantly correlated with age, duration of fever, presence of cardiac disease, B profile and abnormal A lines by lung ULS. However, it is negatively correlated with initial O2 saturation and EF by echocardiography Conclusion: Lung ULS could predict SARS‐CoV‐2 infection among patients with pulmonary symptoms necessitating admission. Lung ULS can also predict the outcome of Covid 19 infected patients.