Pulmonary lymphangioleiomyomatosis

A 38-year-old Iraqi female, presented with one-year history of exertional dyspnea and exercise intolerance, without systemic or constitutional symptoms. Clinical examination revealed bilateral basal crackles with signs suggestive of left side pleural effusion, chest x-ray showed left sided pleural effusion, and diffuse bilateral basal pulmonary shadowing. Her biochemical analysis, hematological tests, electrocardiogram and echocardiography were normal, aspiration of the fluid revealed a chylothorax, the radiological shadowing was proved by computed tomography scan of the chest to be diffuse cystic lesions involving mostly the lower lobes. Open lung biopsy showed dilated lymphatic vessels with surrounding inflammatory cells and smooth muscle fibers consistently with the diagnosis of pulmonary lymphangioleiomyomatosis LAM

Left ventricular hypertrophy in hypertensive patients electrocardiographic and echocardiographic correlations and geometrical patterns

Left ventricular hypertrophy is considered to be an important risk factor for cardiovascular morbidity and mortality. To study the frequency of occurrence of left ventricular hypertrophy in hypertensive patients using the standard ECG and echocardiographic methods, risk factors for its developments and different LVH geometrical echocardiographic patterns. Two hundred and three hypertensive patients [203] and fifty [50] normotensive healthy subjects underwent standard ECG and echocardiographic examinations using internationally accepted formula for the detection of left ventricular hypertrophy. Electrocardiographic detection of LVH was found in 10.3% of hypertensive patients, compared to 50.2% detected by echocardiography with sensitivity of 18.4% and specificity of 91.3%. Concentric hypertrophy was the most common geometrical echocardiographic pattern [23.7%] followed by eccentric hypertrophy [17.3%] and concentric remodeling [15.3%]. Independent predictors of getting LVH were Age, obesity, uremia. Echocardiography is a more sensitive tool than ECG for the detection of left ventricular hypertrophy; concentric geometry is the most prevalent echocardiographic LVH pattern. Age, obesity and chronic renal failure were independent predictors of getting L VH in hypertensive patients