HEART FAILURE CLINICAL MANIFESTATIONS FEATURES IN MYOCARDIAL INFARCTION, COMPLICATED BY THROMBOEMBOLISM, IN MALES UNDER 60 YEARS OLD

Thromboembolism and heart failure are among the most frequent causes of death in myocardial infarction. Purpose of the study. To study the peculiarities of clinical manifestations of heart failure in myocardial infarction complicated by thromboembolism development in men younger than 60 years old to improve prevention and outcomes. Material and Methods. Men 19-60 years old with myocardial infarction type I were included in the study. Patients were divided into age-matched groups. The study group consisted of 29 patients with thromboembolism, control group - without thromboembolism - 658 patients. A comparative analysis of objective manifestations of heart failure in the selected groups was performed. Results. In the study group in comparison with the control group the predominance of the frequency of variants of clinical course of myocardial infarction mixed with heart failure was revealed (in the study group - 32,1%; in the control group - 17,3%, respectively; p˂0,0001), its complicated course (100% and 56,0%, respectively; p˂0,0001) with multiple complications (100% and 44.8%; p˂0.0001), heart failure at the end of the eighth week of illness (77.7% and 42.8%; p=0.03), frequency of observation of cyanosis (89.3%; 67.9%; p=0.02), dyspnea (82.1% and 45.4%; p=0.0001), pulmonary rales (64.3% and 40.5%; p=0.01), arrhythmias (57.1% and 22.5%; p˂0.0001) and liver enlargement (53.6% and 15.8%; p˂0.0001), a measure of patients' quality of life related to heart failure (79.83±17.92 and 60.31±20.46; p˂0.0001). Reliable dynamics of objective signs of heart failure in the studied group was obtained only for dyspnea (p˂0.0001). Conclusions. The patients of the studied group have predominant manifestations of heart failure both in the first hours and at the end of the third week of the disease. Complicated course of myocardial infarction with a variety of their combinations dominates in this group. Dyspnea is the most sensitive symptom to changes in the condition of patients in the study group. In this group there is a high prevalence of heart failure after the eighth week of myocardial infarction.