Background: We studied the diagnostic accuracy of B-lines (comet-tail sign) on bedside lung US, NT-proBNP, E/e` on ECHO in differentiation of the causes of acute dyspnea in the emergency setting. Major advantages include bedside availability, no radiation, high feasibility and reproducibility, and cost efficiency. Methods: Our prospective study was performed at the alazhar university hospital, Cairo, Egypt, between July 2019 and March 2020. All patients underwent lung ultrasound examinations, along with TTE, laboratory testing, including rapid NT-proBNP testing. Results: The median E/e’ levels in patients with B-profile were 18, compared with a median of 7.4 in the subjects with A-profile (P =< 0.0001 CI = -9.649 to -7.044). It was found that the sensitivity and the specificity of detecting B-profile on ultrasound is high when E/e’ > 15.5 (95.0% and 83.0% consecutively), which concluded the high correlation between finding B profile on U/S chest and elevated left ventricle filling pressure in a patient presenting with picture of suggestive of heart failure Conclusion: Chest ultrasound can be used as screening test for the evaluation of patients with suspicion of heart failure with excellent sensitivity and good specificity.
The relevance of the multidisciplinary team of cardiology, obstetrics, and clinical pathology has increased and now demands cooperation to manage cardiovascular diseases during pregnancy. A diverse and skilled team (the "pregnancy heart team") should ideally be included early in the pregnant woman's care when she comes with an acute cardiovascular issue during gestation. Acute cardiac disorders that may develop during pregnancy include heart failure (HF), arrhythmias, coronary artery disease, aortic and thromboembolic events, and mechanical heart valves. Cardiovascular disease is the leading cause of pregnancy-related fatalities in underdeveloped countries [1]. Increasing maternal age and concomitant conditions increased maternal death rates. A multidisciplinary cardio-obstetrics-clinical pathology team must provide preconception counselling to women with pre-existing cardiac issues or a history of preeclampsia. To reduce maternal morbidity and mortality during pregnancy and in the first year after birth, this team must be included as soon as possible. The basics of cardiovascular disease during pregnancy should be understood by both cardiovascular and primary care professionals. The diagnosis and emergency therapy of severe cardiovascular disease during pregnancy at Al-Azhar University, a tertiary care facility in Egypt, are covered in this scholarly research, which also highlights the novelty of paradigms for managing such situations in low-resource countries.
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