| 摘要 |
FIELD: medicine. ^ SUBSTANCE: invention concerns medicine, namely to cardiology. The pharmacological mstress-echocardiography for the patient, including fractional introduction of Dobutaminum from 5 to 40 mkg/kg/min with a 3-minute interval is spent. In the absence of gain of frequency of heart contractions to a submaximum level atropine is entered fractionally on 0.25 mg every minute to a total dose no more than 1.0 mg. Thus against the reached submaximum frequency of heart contractions and proceeding infusion of Dobutaminum sublingually one dose of the aerosolic form of Solutio Nitroglycerini of 1 % is entered. Disturbances of local contractility are estimated initially in rest, at introduction of a small dose of Dobutaminum of 10 mg/kg/min, at introduction of the big dose of Dobutaminum of 40 mk/kg/min after inhalation of Nitromintum and on 5th minute of the regenerative period. If at the patient the atypical stenocardia with "the alternative ischemic cascade", characterised that electrocardiographic changes of ischemic character in the form of depression of segment ST and a ventricular arrhythmia precede disturbance of the local contractility, verified by again appearing zones of a myocardium hypokinesis of a left ventricle which is aggravated with reception of nitrates, presence of muscular ponticuluses of coronary arteries is diagnosed. If at the patient the typical stenocardia with "classical" ischemic sequence of reactions on an echocardiogram and an electrocardiogram which is stopped by reception of nitrates the atherosclerotic stenosis of coronary arteries is diagnosed is defined. If clinico-tool implications of an ischemia are not defined, absence of a lesion of a coronary bed is diagnosed. ^ EFFECT: way allows carrying out differential diagnostics of myocardial ponticuluses of coronary arteries, provides noninvasive technique at high accuracy. ^ 3 dwg, 3 ex |
