[Chiari network and pulmonary embolism].

We present the case of a patient with acute pulmonary embolism, Chiari network thrombus, and deep vein thrombosis in lower extremities. Chiari networks are present in the right atrium in a minority of population and are usually of no clinical significance. On the other hand it may be associated with such pathological changes as patent foramen ovale, intraatrial thrombus, or atrial arrhythmias. In our case thrombus was trapped by a Chiari's network.

[Chiari Network and Pulmonary Embolism].

We present the case of a patient with acute pulmonary embolism, Chiari network thrombus, and deep vein thrombosis in lower extremities. Chiari networks are present in the right atrium in a minority of population and are usually of no clinical significance. On the other hand it may be associated with such pathological changes as patent foramen ovale, intraatrial thrombus, or atrial arrhythmias. In our case thrombus was trapped by a Chiaris network.

[Heart failure in acute myocardial infarction: comparing infusions of nifedipine and nitroglycerin]. / Serdechnaia nedostatochnost' v ostroi faze infarkta miokarda: sravnitel'naia otsenka infuzii nifedipina i nitroglitserina.

The impact of intravenous infusion of nifedipine and nitroglycerin on invasive central hemodynamic parameters and microcirculation was compared in 94 patients with acute myocardial infarction complicated by heart failure. The artery dilating effects of nifedipine were associated with baseline peripheral vascular tone, so the comparison was made separately in the groups with and without vasoconstriction. Nifedipine seems to be beneficial in the management of heart failure due to acute myocardial infarction in patients with systemic vasoconstriction. In patients with severe pulmonary congestion and normal left ventricular afterload, the intravenous vasodilators are preferable.

[Use of intravenous nifedipine in the treatment of cardiac insufficiency in the acute period of myocardial infarction]. / Primenenie vnutrivennoi formy nifedipina v terapii serdechnoi nedostatochnosti u bol'nykh v ostrom perriode infarkta miokarda.

The efficacy of intravenous nifedipine was examined in 42 patients with acute myocardial infarction complicated by congestive heart failure. In patients with a higher systemic arteriolar tone, its normalization caused an increase in cardiac output and tissue oxygen supply with a concomitant decrease in pressures in the lesser circulation and the right heart. In contrast, a cardiodepressive effect of the agent was shown in more than a half of the patients with para-normal values of peripheral vascular resistance. The latter is one of the determinants in selecting patients with acute heart failure to be treated with nifedipine.

[Disorders of hemodynamics and pulmonary gas exchange in the acute period of myocardial infarct]. / Narusheniia gemodinamiki i gazoobmena v legkikh v ostrom periode infarkta miokarda.

In 40 patients with massive myocardial infarction, the central hemodynamics was examined by probing the right-sided chambers of the heart and the pulmonary artery. The cardiac output was measured by thermodilution. The gas exchange (respiratory minute volume, capnography, gas analysis of arterial and mixed venous blood) was explored. Arterial hypoxemia was found to be associated with increased intrapulmonary blood shunting in patients with acute myocardial infarction complicated by congestive heart failure. Deterioration of arterial hypoxemia was promoted by a combination of increased overall pulmonary shunting and decreased residual venous oxygenation. Abnormalities in the ventilation-perfusion relations are of great importance.

[Use of beta-adrenoblockaders in the therapy of the syndromes accompanying acute myocardial infarct]. / Ispol'zovanie beta-adrenoblokatorov v terapii nekotorykh sindromov, soprovozhdaiushchikh ostryi infarkt miokarda.

The use of beta-adrenoblockers in patients with acute myocardial infarction, accompanied by hypertension and hyperdynamia, leads to normalization of the arterial pressure, of parametres of haemo- and cardiodynamics, to a decrease of the degree of ischaemia of the damaged myocardium and to an increase of the heart work efficacy.