Features of clinical and sonographic symptoms in chronic pancreatitis with ischemic heart disease

Abstract

Aim of the study. To investigate the features of the clinical course of chronic pancreatitis in comorbidity with ischemic heart disease.Research methods. We used a survey, anamnesis, objective examination, biochemical, radioimmune (indicators of insulin in the blood), instrumental (sonographic, ECG), statistical (computer analysis of data). The criteria for inclusion in chronic pancreatitis were exacerbations, abdominal pain and dyspeptic syndrome, sonographic changes in the pancreas, risk factors, patient consent for the study. The criteria for inclusion in ischemic heart disease were stable exertional angina FC I-II, CHF IIA-B, FC II-III (NYHA) in the absence of angina attacks within 3 months; regular treatment for 3 months, patient's consent. The exclusion criteria included oncological diseases, acute exacerbations of CP, myocardial infarction in the last 3 months, chronic kidney disease, and diabetes mellitus. The study was carried out in accordance with the Order of the Ministry of Health of Ukraine No.281 dated 1.11.2000. The study guidance and informed consent form were approved by the Commission on Biomedical Ethics of Bukovina State Medical University.Results. The aggravating nature of the course of the disease, the polymorphism of clinical symptoms, especially the pain syndrome, which did not always have a clear localization, irradiation, intensity and was absent in about 15%, was established. The atypical course in 83.3% of cases was associated with diseases of the digestive system. In 70.0% of patients, atherosclerotic changes in the vessels of the abdominal cavity were revealed, in 47.5% of them, lesions of the carotid artery at the stage of atheromatous plaque or its atherothrombosis, stenosis of the vascular lumen and hemodynamic disturbances were diagnosed. There was a tendency to a decrease in the ejection fraction, cardiac and stroke volumes against the background of an increase in the end systolic volume (ESV), end diastolic volume (EDV) with an EF of 50.4 ± 2.3%.Conclusion. The clinical course of chronic pancreatitis in comorbidity with ischemic heart disease is characterized by prolonged formation (more than 10 years), accompanied by structural and morphological changes in the pancreas of a fibrosing nature, the presence of atherosclerotic changes in the carotid arteries, atherosclerotic lesions of the aorta, mesenteric dysfunction, diastolic course, the possibility of premature fatal cardiovascular problems and the association with concomitant gastroenterological diseases.