الفهرس | Only 14 pages are availabe for public view |
Abstract SUMMARY AI”D CONCLUSION Thalassmias are a heterogenous group of heretable hypochromic anemias of various degrees of severity. Thalassemias is the most common type of chronic hemolytic anemia in Mediterranean countries. It consists of several genetically determined disorders due to unequal synthesis of hemoglobin chains that causes ineffective erythropoiesis. Thalassemias have several complications but the main cause of death is still heart failure caused by hypoxia, cardiac hemosiderosis and hyperdynamic circulatory overload. The aim of this study is to assess some cardiac and pulmonary changes in patients with beta-thalassemia major. The study was conducted on 25 beta-thalassemia major patients selected from the pediatric clinic ofBenha University hospital. Their ages ranges from 5.4 to 15 years. 25 apparently healthy children age and sex matched are studied as a control group. Echo-Doppler was done to all patients where it can detect early cardiac complications of beta-thalassemia major and demonstrated that cardiac dilatation occurs in thalassemics as indicated by increased LVEDD and LVESD. LVEDD was increased more frequently. LYM was significantly greater in cases than control group. FS and EF were impaired in a small number of patients (8%) who shows no signs of heart failure clinically. Pulmonary hypertension appeared 111 20% of patients diagnosed by pulmonary acceleration time. Right ventricular function was assessed by tricaspid E/A ratio where (20%) patients only showed reversed E/A ratio indicating right ventricular dysfunction. ECG was done to all patients and the most common abnormality detected was left ventricular hypertrophy. Chest x-ray was done to all patients and revealed cardiomegaly in 7 (28%) patients. The above results showed that echocardiography can detect early cardiac complications of beta-thalassemia major. Left ventricle was affected more than the right ventricle in thalassemics. Pulmonary function assessment was done to all patients. That revealed restrictive pattern of pulmonary function, obstructive element was also detected. Pulmonary function abnormalities were due to pulmonary hemosiderosis, hypoxemia, cardiac damage, decreased alveolar growth and pulmonary vascular involvement by microthrombosis. |