Peculiarities of cardiac performance in children with bronchial asthma against chronic tonsillitis

A comparative assessment of cardiac performance by the data of clinical-instrumental examination of 50 patients aged 5-15 years with persisting form of partially-controlled atopic bronchial asthma in the period between the attacks of the disease was made. Children were divided into two groups depending on presence of concomitant chronic tonsillitis (18 patients) or absence of the latter (32 patients). In all cases by the data of spirography in children against chronic tonsillitis in the period between the attacks of the disease there were revealed ventillation disorders in the lungs by obstruction type, this promoted elevation of pressure in the pulmonary artery. Only in this group of patients in 27,8% of cases pulmonary arterial hypertension of moderate severity was revealed. By echocardiography data in children with asthma against chronic tonsillitis reliably more often (р<0,01) there was revealed decrease of contractile function of myocardium of the left cardiac ventricle; this was caused by the presence of metabolic disturbances in the myocardium in the majority of cases (83,3%). These changes were registered on the electrocardiogram in the form of repolarisation changes of the ventricular complex. Presence of concomitant chronic tonsillitis in children with bronchial asthma favored formation of pulmonary hypertension on the one side and worsening of contractile ability of myocardium of the left cardiac ventricle on the other side; this required performing therapeutic-preventive measures for sanation of chronic infectious focus in the nasopharynx to prevent formation of chronic cardiac insufficiency during asthma course.