Vovchenko M. Optimization of treatment of ischemic heart disease combined with gastroesophageal reflux disease in women during perimenopause.

The thesis is devoted to optimization of treatment of ischemic heart disease (IHD) in combination with gastroesophageal reflux disease (GERD) in women during perimenopause by studying the characteristics of clinical manifestations associated pathology in the dynamics of antianginal therapy. It is proved that women in perimenopause have atypical pain much more frequently if they have IHD and GERD at the same time. It is shown that in the group with combined flow of IHD and GERD the type of pain determines the severity of menopause and hypertension. It has been established that with the level of FSH<25 IU/L 89,47 % of patients have typical complaints for atypical pain, and with the level of FSH?25 IU/L the number of patients with atypical pain syndrome decreased to 57,89 %. In patients with combined IHD and GERD a reliable low level of stable metabolites of nitric oxide, lower quality of life and more hot flashes per day are detected. It was shown that L-arginine and trimetazidine show comparable antianginal effect and do not make worse the flow of GERD. The additional prescription of L-arginine instead of trimetazidine in patients with combined IHD and GERD definitely increase the level of stable nitric oxide metabolites, improves quality of life and reduces the symptoms of menopause.