Clinical features of acute myocardinal infarction in patients with chronic obstructive pulmonary disease, impact of drug therapy
Nowadays the problem of comorbidity of cardiac artery disease (CAD) and chronic obstructive pulmonary disease (COPD) is a complex, diverse and still poorly studied. Comparative analysis of the clinical features of acute myocardial infarction (AMI) in patients with COPD and without COPD has been performed in the study. It has shown that in patients with AMI diagnosis of COPD is exposed on the basis of the medical history, clinical course that is a complex of syndromes: bronchitic, bronchoobstructive and lung emphysema. It has been found that patients with COPD are more likely to have a history of attacks of angina pectoris, congestive heart failure and ischemic stroke; often the duration of the AMI complicated by cardiac arrhythmias, recurrent myocardial infarction, hospital and high annual mortality in comparison with the patients without COPD. On admission respiratory symptoms have been recorded not only in patients with COPD, but also in long-term smokers with AMI without COPD. In the treatment of acute myocardial infarction in patients with COPD β-blockers have been used in 74%, they have been canceled in 22% in the first 5 days of treatment of the main disease and in 17.4% due to the increase of bronchoobstructive syndrome. Major bronchodilator drugs for the treatment of COPD patients in acute myocardial infarction period were M-cholinolitics and combination (β2-agonist and glucocorticosteroid) drugs, the use of which has shown no adverse effect on the cardio - vascular system.