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© КОЛЛЕКТИВ АВТОРОВ, 2018 UDC 616.24-008.4/12-07
A. Chesca1, A. B. Marchenko2, A. S. Akhaeva2
STUDY OF PATIENTS WITH ACUTE RESPIRATORY PATHOLOGY WITH PACEMAKER IMPLANT
1Transilvania University of Bra§ov, Clinical Hospital of Pneumophtysiology (Bra§ov, Romania), 2Karaganda state medical university (Republic of Kazakhstan)
Currently, cardiovascular and bronchopulmonary pathologies are the most urgent medical and social problems, in connection with maintaining a high level of mortality and morbidity. The present paper aims to bring attention to selected cases of patients who have carried out medical examination of acute respiratory symptomatology. Selected patients for the present study have comorbidities, acute and/or flare-up of chronic respiratory diseases and cardiovascular diseases requiring a pacemaker implant. Following routine investigations, including standard chest x-ray and anamnesis, had shown the combination of respiratory and cardiac symptomatology. This study also increased awareness of their condition, risks in patients with these diseases.
Key words: X-ray imaging, respiratory pathology, cardiovascular diseases, pacemaker
Respiratory pathology, by various symptoms worsen the quality of life and guide patients to medical specialized examinations [3, 12, 13]. In many situations, respiratory diseases affect patients of vulnerable ages, which contact with viruses, bacteria or fungi, that affect different segments of the upper airway or the lungs [8,
14].
Frequently, in all seasons of the year, but especially in the cold season, patients with cardiovascular disease are present in specialized departments with pneumophysiological profile [6]. We draw attention to elderly patients of both genders, who at the standard chest x-ray imaging investigation have present a pacemaker [1, 2]. Situations leading to the pacemaker implant are certain types of atrioventricular blocks, atrial fibrillation, carotid sinus hypersensitivity syndrome, sinus bradyarrhythmia, sinus node diseases [10,
15]. Artificial medical pacemaker is a device that uses electrical impulses, leading to myocardial function within normal limits, with a sustained, regular, rhythm of contraction capacity [7, 11].
In our practice such patients, are still relatively rare, in this regard, we pay them more attention. Radiological observation of the pacemaker, requires at least taking an anamnesis of the patient's cardiovascular disease associated with acute respiratory symptomatology [5, 9].
Aim of research was to improve diagnosis, medical awareness and adherence to therapy of patients with acute or chronic respiratory pathology with chronic cardiovascular diseases requiring a pacemaker implant.
MATERIALS AND METHODS
In order to obtain this material, were selected patients, who have been presented for pneumological consultation and who have described associated cardiovascular disease in their anamnesis and being carriers of the pacemaker.
The patient's gender, age, home environment, diagnostic features of cardiovascular and respiratory diseases are considered. All patients from the present study were from urban residence area. The study involved 14 people, 78.57% (n=11) men and 21.43% (n=3) women. All examined were divided into two groups. First group was surveyed in the second quarter of 2016, 83.33% (n=5) men and 16.67% (n=1) female, the second group in the third quarter of the same year, 75% (n=6) men and 25% (n=2). In routine examinations such as standard chest X-ray, a pacemaker implant was observed at all patients.
RESULTS AND DISCUSSION
The results of distribution of patients by gender showed on the figures 1, 2, 3. As shown in the diagram, there is a prevalence of male to female in general number of patients and in both groups. Differences in distribution between the two groups were not significant.
The predominance of men in the study reflects the fact that male sex is one of the main, unmodified risk factors for the development of cardiovascular diseases and their complications. It is also noted, that the male population has a higher percentage of smokers, which also increases cardiovascular risk and in particular the risk of developing persistent arrhythmias requiring the installation of a pacemaker [4].
The result of the sample distribution by age group is shown in Table 1. All patients were divided into 6 age groups with an interval of 9 years.
The most common age group, which is represented in the study, was a group of patients from 61 to 70 years, mainly due to the male population. In the second place were patients of the group <50 years old, with a uniform distribution across the sex.
Cardiovascular diseases from the selected
Table 1 - Sample distribution by age group
Age group, years < 50 51-60 61-70 71-80 81-90 < 90
General population
Cases, n (%) 2 (14.29) 1 (7.14) 8 (57.14) 1 (7.14) 1 (7.14) 1 (7.14)
Male population
Cases, n (%) 1 (9.1) 1 (9.1) 7 (63.63) 1 (9.1) 0 (0) 1 (9.1)
Female population
Cases, n (%) 1 (33.33) 0 (0) 1 (33.33) 0 (0) 1 (33.33) 0 (0)
Figure 1 - Distribution of patients by gender, in Figure 2 both groups group 1
Distribution of patients by gender,
Figure 3 group 2
Distribution of patients by gender,
patients of the study were bundle branch block, sinus node disease, myocardial infarction, val-vulopathy, heart failure; for example in one decompensated case, male patient 96 years old, was diagnosed pleural effusion.
The study continued, but in the manner of presenting suggestive radiological images (fig. 1, 2). Considering that the male gender is more affected than female gender, standard chest X-ray will be shown in two symptomatic patients with respiratory signs and symptoms, presented in specialized medical services, in the first quarter of
2018. The study could be continued from different perspectives.
CONCLUSION
The combination of bronchopulmonary pathology with cardiovascular diseases, in particular, with heart rhythm disorders requiring the implantation of a pacemaker, significantly increases the risk of nonfatal (main disease prognosis worsening) and fatal complications such as a heart attack, stroke and pulmonary embolism. This, in turn, increases the importance of timely diagnosis and pathogenetic treatment of pulmonological pathology, consultation of pulmonologist. With each of the examined patients, was hold a conversation on the need for timely consultation with related specialists, recommendations for further examination and treatment are detailed.
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Received 02.02.2018
А. Ческа1, А. Б. Марченко2, А. С. Ахаева2
ВЕДЕНИЕ ПАЦИЕНТОВ С ОСТРОЙ РЕСПИРАТОРНОЙ ПАТОЛОГИЕЙ И КАРДИОСТИМУЛЯТОРОМ 1 Университет Трансильвании г. Брашов, Клинический госпиталь фтизиатрии (г. Брашов, Румыния), 2Карагандинский государственный медицинский университет (Караганда, Казахстан)
В настоящее время сердечно-сосудистая и бронхолегочная патология являются наиболее неотложными медицинскими и социальными проблемами в связи с высоким уровнем смертности и заболеваемости. Представ-
ленная работа направлена на привлечение внимания к отдельным случаям ведения пациентов, которым было проведено медицинское обследование острой респираторной симптоматики. Отобранные для исследования пациенты имели сопутствующие заболевания, острое и/или внезапно начавшееся хроническое респираторное заболевание и сердечно-сосудистые заболевания, требующие использования кардиостимулятора. После рутинных исследований, которые включали в себя стандартную рентгенографию и анамнез грудной клетки, была выявлена комбинация респираторной и сердечной симптоматики. Настоящее исследование также повысило осведомленность состоянии, рисках у пациентов с этими заболеваниями.
Ключевые слова: рентгенография, респираторная патология, сердечно-сосудистые заболевания, кардиостимулятор
А. Ческа, А. Б. Марченко2, А. С. Ахаева2
6ТК1Р РЕСПИРАТОРЛЫККК ПАТОЛОГИЯМЕН ЖЭНЕ КАРДИОСТИМУЛЯТОРМЕН ПАЦИЕНТТЕРД1ЕМДЕУ Трансильвания университет, Брашов ;аласы, Клиникалы; фтизиатрия госпитал1 (Брашов ;аласы, Румыния), 2КараFанды мемлекеттк медицина университет (КараFанды, Казахстан)
К,аз1рп уакытта жYрек-буын жэне тыныс алу-екпе патологиясы ауыру менел1м-жтмн1н жорары денгей1не байланысты барынша шурыл медициналы; жэне элеуметпк мэселелер болып табылады. ¥сынылран жумыс пациенттерд1 емдеудН жекелеген жардайларына назар аударура барытталран, оларра етюр респираторлы; симптоматикара медициналы; тексеру жYргiзiлген. Зерттеу Yшiн 1р1ктелген пациенттердщ ;осал;ы аурулары, етк1р жэне/немесе кенет басталран созылмалы респираторлы; ауруы мен кардиостимулятор пайдалануды талап етет1н жYрек-буын аурулары болран. Стандартты; рентгенография мен кеуде клеткасынын анамнез! сия;ты кептеген зерттеулерден кей1н, респираторлы; жэне жYрек симптоматикасынын комбинациясы аны;талды. Осы зерттеу сол сия;ты осы аурулармен пациенттердН жар,дайы, ;атерлер1 туралы хабардар болуларын арттырады.
Клт сездер: рентгенография, респираторлы; патология, жYрек-буын аурулары, кардиостимулятор.
