[Tolerance for physical loading in patients with a history of pulmonary thromboembolism].
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Biomedical subjects
Publications and source records attributed to I G Kostenko.
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Haemodynamic studies were undertaken in 30 patients with chronic post-embolic pulmonary hypertension (CPEPH), and the findings were compared with those found in acute thromboembolism of the pulmonary artery. The study showed that radiocardiographic examination is a useful supplementary method for diagnosing postembolic lesions of pulmonary arteries and for dynamic examination of patients after pulmonary embolism. The appearance of a "single-hump" curve on the radiocardiogram was an unfavourable prognostic sign and attested both to an increase of pulmonary hypertension or to a latent heart failure. The importance of radiocardiographic examination for determining the prognosis of the disease and for choosing the most suitable method of its treatment is analysed.
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The use of electro- and echo-graphic examinations in patients with chronic post-embolic pulmonary hypertension allowed the identification of the most sensitive signs of right ventricle hypertrophy which made it possible to assess objectively the state of the cardiac muscle.
Variations in coronary blood flow and cardiac output were studied using dopplerography throughout rationed exercise in 16 patients with chronic postembolic pulmonary hypertension. All patients showed reduced coronary flow during exercise, an evidence of early signs of coronary insufficiency. A correlation was demonstrated between coronary flow disorders and the severity of pulmonary hypertension, the extent of pulmonary vascular bed lesion and right-ventricular hypertrophy.
Characteristic hemodynamic manifestations of pulmonary artery thromboembolism include a decrease in both the volume and the time of pulmonary blood flow. The reaction of the cardiac output in response to pulmonary artery thromboembolism may assume the form of three types of circulation attended by volumetric alterations.
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The two-system phlebotonometry of lower extremities in 50 patients with varicose disease enabled the authors to make a conclusion about the great role of the duration of that phase of diastole when the blood runs from superficial veins into deep ones promoting the evacuation of the congested blood. This phase was found to be considerably shorter and even to disappear completely in patients at the decompensation stage. The drainage function of the musculo-venous "pump" is disturbed in patients with the varicose disease of the lower extremities and the degree of its insufficiency is in direct relation with the degree of the disease.
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Data covering 177 cases of the atrioventricular block where cardiostimulation was effected by using Soviet-made batch-produced electrocardiostimulators are analyzed. The largest group included patients 50 to 70 years old (71 per cent). In 47 per cent of the cases the atrioventricular block stemmed from ischemic heart disease. As indications for cardiostimulation served the Morgagni-Adams-Stocks syndrome and a well-marked circulatory insufficiency. The hospital lethality comprised 15.8 per cent. The death was caused by acute cardio-pulmonary incompetence, thromboembolism of the pulmonary artery and myocardial infarction. Among complications secondary to cardiostimulation figure suppuration of the operating wound, disturbed integrity of the myocardial electrodes and a premature exhaustion of the cardiostimulators reserves. From among 130 patients kept under observation the duration of cardiostimulation comprised: up to 1-year--in 20.7, from 1 to 3 years--in 26.1, from 3 to 5 years--in 20.7, from 5 to 10 years--in 1m.7 and over 10 years--in 14.8 per cent.
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