Clinical picture and diagnosis of myocardial infarction in patients with rheumatic heart disease

Myocardial infarction is extremely rare (0.64-0.8%) complicates the course of coronary insufficiency in rheumatism [2, 10, 17] and is very often not recognized, since rheumatic heart defects and myocardial infarction lead to cardiac dysfunction and are manifested by a complex of many the same symptoms. It is known that pain in the form of paroxysmal chest pain with irradiation characteristic of angina pectoris are quite frequent companions of aortic stenosis, severe insufficiency of the semilunar aortic valves, and a high degree of mitral stenosis. With rheumatic heart disease in the active stage, pain syndrome with coronary features may occur in rheumatic coronaritis and in some cases give rise to an erroneous diagnosis of myocardial infarction [1, 3, 7, 13, 24]. In some cases, the clinical picture of myocardial infarction and ECG data are generally unclear. All this complicates the diagnosis of myocardial infarction in patients with rheumatic heart disease. Along with this, it should be noted that the pathogenesis of focal changes in the myocardium in rheumatism is not entirely clear.