Клинико-функциональное обоснование метода новокаиновых блокад внутригрудных артерий на стационарном этапе комплексной терапии больных ишемической болезнью сердца

Aim . Clinical and functional prove for using of modified Novocain block of internal thoracic arteries during inpatient coronary heart disease (CHD) treatment. Material and methods. In total, 117 CHD patients, males and females of 32-78 years, were divided into two groups. Group I consisted of 50 CHD patients receiving antianginal therapy. Group II consisted of 67 CHD patients, who received not only standard antianginal treatment, but also Novocain blocks of internal thoracic arteries (3 procedures with 2-3-day intervals). Treatment effectiveness was assessed by clinical and instrumental methods: electrocardiogram (ECG), late ventricular potential (LVP) registration, Holter monitoring, echocardiography (EchoCG), and color tissue Doppler EchoCG (TDE). Results. Internal thoracic artery block improved patients’ status: angina episodes’ number and / or intensity decreased, workload tolerance increased, night sleep normalized. Besides, ST depression and LVP disappeared or reduced, autonomous cardiac regulation improved, QT interval and extrasystole number decreased, that cut the risk of fatal arrhythmias. The method improved the velocity of basal LV segment movement, according to TDE. This inexpensive method, included into complex CHD management, reduced mean hospitalization time by 7 days. Conclusion. Novocain internal thoracic artery block might be a method of choice in complex treatment of resistant angina.