Лечащий Врач (Aug 2024)
Clinical features of the course of various forms of acute coronary syndrome in patients with diseases of the upper gastrointestinal tract
Abstract
Background. Diseases of the upper gastrointestinal tract and acute coronary syndrome have similar manifestations of pain syndrome, which may contribute to the patient's postponement of seeking medical help with the development of acute coronary events. There is a direct correlation between the risk of acute heart failure and the duration of pain syndrome, the time from its onset until the patient receives antiaggregant therapy. Thus, it is relevant to study the peculiarities of the course of acute coronary events in patients with diseases of the upper gastrointestinal tract in order to optimize the provision of timely medical care.Objective. The purpose of the research was to evaluate the clinical features of different forms of acute coronary syndrome in people with pathology of the upper gastrointestinal tract.Materials and methods. The analysis of the characteristics of pain syndrome, as well as other manifestations of acute coronary syndrome, was carried out in 39 patients with diseases of the upper gastrointestinal tract compared with a group of 40 people without concomitant pathology of the gastrointestinal tract. The groups did not differ in gender and age characteristics. A special questionnaire has been developed for this work.Conclusion. It was found that in the presence of pathology of the upper gastrointestinal tract, acute coronary syndrome was accompanied by asthenic syndrome in 77% of cases (p = 0.02), and in unstable angina, this figure reached 83% (p = 0.003). Significantly more often (67%) manifestations of heart failure were in patients of the main group with unstable angina pectoris (p = 0.025). Acute coronary syndrome in patients with concomitant pathology was accompanied by epigastric pain in 15% of cases (p = 0.03), and acute myocardial infarction – in 19% (p = 0.02). Posterobasal localization of myocardial damage was established only in patients of the main group with acute myocardial infarction in 15% of cases (p = 0.039). All this indicates the need to take an electrocardiogram in leads V7-9 in the presence of epigastric pain in patients with diseases of the upper gastrointestinal tract.
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