[The course of ischemic heart disease in rheumatic defects in persons over 45].

Coronary heart disease (CHD) was followed up in 239 patients with rheumatic heart disease. According to the clinical data 40 (16.73%) patients had myocardial infarction (MI), 100 (41.84%) cardiosclerosis (CS), 185 (77.4%) angina pectoris (AP). AP (44.35%) prevailed among the isolated (66.1%) forms of valvular disease, associated AP and CS (23%) among the combined (33.9%) forms. In the majority of patients, AP originated and ran its course as stable throughout many years; in one-fifth of patients, the disease occurred as unstable. The incidence of AP was significantly higher in the senior age group, in women with aortic valvular disease, in men with stage III circulatory failure, and in cardiomegaly, AP aggravated the disease and life prognosis. MI was manifested by a moderately pronounced painful attack; it was frequently complicated by acute or incremental chronic circulatory failure. Small-focal MI was seen more frequently while the electrocardiographic changes associated with the disease resembled those seen in rheumatic carditis. Postinfarction CS stimulated the onset and progress of chronic congestive heart failure in 93.02% of patients.