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Background: Chronic valvular heart disease leads to systolic dysfunction and left atrial enlargement that ultimately results in heart failure.Purpose: To investigate prognostic importance of Echocardiography and plasma natriuretic peptide levels that increase as a compensatory response and can be used as predictive markers for cardiac hypertrophy.Material and Methods: The patients were divided into three groups: 51 with left ventricle hypertrophy due to aortic valve disease; 126 with left atrial enlargement due to mitral valve dysfunction; and 76 with both conditions. Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) plasma levels were measured in all three respective groups showing dilated cardiomyopathy.Results: The mean left ventricular end-diastolic dimension at 64.3 ± 1.6 mm (P < 0.00) and left atrial dimension at 58.3 ± 3.7 mm (P < 0.00) were significantly high. However, patients with both conditions showed significantly high values for left ventricular end-diastolic dimension (63.3 ± 3 mm, P < 0.00) and left atrial dimension (54.9 ± 4 mm, P < 0.00) when compared with controls. A significant positive correlation was found between plasma natriuretic peptides levels and dilated cardiomyopathy. The mean values of ANP were 173 ± 46.6 pg/mL (P < 0.00), 140.4 ± 42.4 pg/mL (P < 0.00), and 295.1 ± 67.5 pg/mL (P < 0.00), significantly high in all three respective disease groups. The levels of BNP were also significantly high at 189 ± 44.5 pg/mL (P < 0.00), 166.6 ± 36.6 pg/mL (P < 0.00), and 323 ± 69.1 pg/mL (P < 0.00) in the disease groups with left ventricular hypertrophy, left atrial enlargement, and the disease group showing both characteristics, respectively.Conclusion: Significant positive associations were found between left ventricle hypertrophy and left atrial enlargement with ANP and BNP. [ABSTRACT FROM AUTHOR]

Both the fetus and mother are under tremendous life threatening stress in case of an aortic dissection during pregnancy. We present case of a 25 years old diagnosed case of Marfan Syndrome primigravida at 29 weeks of gestation. The patient wa6s referred from a clinic due to nausea, vomiting and dyspnea. Aortic dissection ( AD) was evident upon Echocardiography. The patient was under observation when she suddenly developed jaw, chest and back pain. Her first degree relative (father) had died due to an AD at the age of 25. The patient was resuscitated and all possible medical efforts were taken along side an emergency cesarean section but the patient died soon after the delivery. Awareness needs to be raised in such medical cases and a clinical approach needs to be developed for critical care of pregnant patients. Proper surgical techniques and use of better medical technology are required to make and early diagnosis. Further studies/ case reports around the world would assert our findings and lead to better treatment options. [ABSTRACT FROM AUTHOR]