THE CLINICAL AND FUNCTIONAL FEATURES OF CORONARY HEART DISEASE IN PATIENTS WITH STENOTIC CEREBRAL ATHEROSCLEROSIS
Objective: to study the clinical features of coronary heart disease (CHD) in the presence of internal carotid arterial stenosis. Subjects and methods: 163 patients with coronary stenosis were examined and divided into 2 groups were divided into 2 groups: 1) 84 patients with concurrent lesions of the coronary and cerebral beds; 2) 79 patients with isolated coronary lesion. Stenotic cerebral atherosclerosis was diagnosed by duplex scanning of the internal carotid arteries (ICA). Transesophageal pacing and 24-hour ECG monitoring were used to detect latent coronary insufficiency in patients with stenotic ICA atherosclerosis. Results: It has been found that as cerebral atherosclerosis progresses, a) there is a rise in the number of patients with prior acute myocardial infarction due to its large focal forms; b) there is an increase in the frequency, duration, and magnitude of ischemic changes and dysfunction of the sinoatrial conduction; c) according to the degree of stenosis, a fourth of the CHD patients with ICA stenosis experience atypical cardialgia; as ICA stenoses progress, the number of patients with silent myocardial ischemia increases from 10.0% to 32.1%. Conclusion: Progression of an atherosclerotic process occurs concurrently in two vascular beds (coronary and cerebral). The distinguishing clinical features of CHD in the presence of cerebral atherosclerosis are the higher incidence of its silent forms the diagnosis of which requires ECG monitoring and exercise tests in patients with stenotic cerebral atherosclerosis.