CLINICAL AND FUNCTIONAL CRITERIA OF CORONARY ARTERY DISEASE IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASES
DOI:
https://doi.org/10.11603/1681-2786.2019.2.10483Keywords:
CAD, COPD, clinical manifestations of CAD, 24-hour ECG monitoring, echocardiography, spirometryAbstract
Purpose: to determine the clinical and functional features of coronary artery disease in comorbid cardiorespiratory pathology and to identify its most informative diagnostic criteria in patients with COPD.
Materials and Methods. Therе were examined 153 male patients, including 44 patients with stable coronary artery disease (CAD), 53 people with a diagnosis of сhronic obstructive pulmonary disease (COPD) and 56 patients with a combination of COPD and stable CAD. The complex of studies included a complete blood and urine test, a profile of biochemical analyzes, computer spirometry, pulse oximetry, chest x-ray, electrocardiography (ECG), 24-hour Holter ECG monitoring, transthoracic echocardiography.
Results. COPD is characterized by high morbidity, mortality and disability, which leads to significant economic costs for society, loss of working capacity of the population and a significant decrease in quality of life. Cardiovascular diseases (CVD) are the main cause of death in patients with COPD, constituting approximately 50 % of the total number of deaths. Early diagnosis of the most common CVD – CAD in patients with COPD, is difficult because of the similarity of a number of symptoms, the low informativeness of a routine electrocardiogram (ECG), as well as the characteristics of clinical manifestations, when one disease leaves another in the shadow. The specific features of coronary artery disease in patients with COPD are atypical manifestations of angina pectoris, a high incidence of painless myocardial ischemia and contravention of cardiac rhythm according to Holter ECG, an increase in the frequency and degree of dyspnea, partially equivalent of angina pectoris. Affiliation CAD to COPD contributes to a more significant increase in pressure in the pulmonary artery and the most pronounced, significantly different from other groups, remodeling of the left heart, which is associated with the degree of bronchial obstruction.
Conclusion. Affiliation CAD to COPD aggravates the course and modifies the clinical picture, complicating the diagnostics of diseases, which necessitates carrying out daily monitoring of ECG and echocardiographic studies in patients with COPD.
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