THE COURSE OF ISCHEMIC HEART DISEASE IN PATIENTS WITH OBLITERATING THROMBOANGIITIS OF OWER EXTREMITIES

G.M.ZEYNALOVA, N.S. ABISHOV, E.D. ZAKIRJAYEV, Z.M.ALIYEV

Scientific Center of Surgery named after acad. M.A. Topchubashov, Baku,AZERBAIJAN

Introduction. At present, obliterating thromboangiitis (OT) is of considerable interest both from in the terms of therapeutic treatment and optimization of surgical assistance to such category of patients. The frequency of combination of ischemic heart disease (IHD) with OT of lower extremities ranges between 8 - 12%. Timely detection of painless myocardial ischemia and oligosymptomatic IHD in patients with OT of lower extremities will allow to properly assess the cardiac risk during surgical interventions and develop a differentiated therapeutic tactics.

Materials and methods. 150 patients were examined, of which 144 were men and 6 -women. Age of patients ranged between 24-54 years. Average age - 40,88 ± 0,52 years. Lower extremity ischemia of 3^rd-4^th stages was diagnosed in all the patients (acc. to R. Fontaine). Generally, the surveyed did complained of pains of anginal nature. 17 patients complained of casual and rare short-term pains in the left side of the chest of cardialgia type not associated with physical activity. 16 patients had concomitant hypertension. All patients were exposed to ECG in 12 lead with Kardiet-ar-1200 electrocardiograph.

Results: During ECG, 12 (8%) patients had signs of myocardial infarction which were recorded on the ECG QRS in the form of QS, QR, changes of S-T segment and T wave – S-T segment depression and flattening or inversion of T-wave in respective leads subject to wall lesions. In 51 (34%) patients there was observed sinus tachycardia, in 8 (5.3%) - extrasystolic arrhythmia, in 19 - left ventricular hypertrophy, block of His' bundle. 138 (92%) patients were reported to have various degrees of T-wave flattening, which was the result of myocardiodystrophy.

Conclusions. Thus, the course of IHD in patients with OT of lower extremities is characterized by an apparent polymorphism. Deficiency of coronary reserve in this group of patients is presented as both a painless myocardial ischemia and stenocardia of tension of different functional classes. In patients with OT of lower extremities ischemia it is necessary to consider the possible risk of coronary complications during various surgical procedures and to conduct an adequate pre-operative cardiac correction.

Date: 2014-12-28; view: 854