Characteristics of peptic ulcer in subjects with concomitant coronary heart disease

Aim. The study of clinical running of gastric or duodenal ulcer in associated coronary heart disease (CHD). Materials and Methods. 209 CHD patients with gastric ulcer (CU) or duodenal ulcer (DU) were examined clinically plus histological examination of gastric or duodenal mucosa biopsies was made. Results. In CHD patients CU occurred more frequently (56%) than DU. The lesions involved more frequently lesser curvature of the stomach and pyloric part of the stomach. Males developed ulcers 3.5 times more frequently than females. Ulcers tended to a painless course, without season exacerbations. The disease manifested first with gastric bleeding in 52% of the patients. CU and DU ran with frequent recurrences and long-term exacerbations (76% of patients) which coincided in time with CHD exacerbations. 68% of patients developed exacerbations within 10 days after myocardial infarction or aortocoronary bypass operation. Helicobacter pylori was present as a resolving factor in arising ulcer in 26% of patients. Microcirculatory disorders, reduced bloodflow speed in gastric or duodenal mucosa, hypocoagulation syndrome, dyslipidemia provoked exarbations in 62% of patients. Examinations of biopsies from gastric and duodenal mucosa showed marked dystrophic changes in the mucosa, ifs connective tissue basis in the vessels in the presence of mild inflammation at ulcer, site. Conclusions. The onset of ulcers and erosions in the mucosa of the gastrointestinal tract in CHD may be dice to circulatory disorders in gastric mucosa. The main factors of aggression are hypoxia, hypoxia-induced trophic defects in gastric and duodenal mucosa, circulatory disorders.