[Rheologic disorders in myocardial infarct complicated by acute left ventricular failure]

Thirty-six patients with acute myocardial infarction aggravated by acute left ventricular failure (pulmonary edema, cardiogenic shock) were studied for their blood rheologic properties. The impairments of the blood rheologic properties were classified as Stage I and II syndromes of high and low blood viscosity and were characterized by a phasic nature of their course. The rheologic disorders associated with pulmonary edema and reversed cardiogenic shock were decompensated (Stage II syndrome of high blood viscosity--Stage I syndrome of low blood viscosity), but reversible following intensive rheologic therapy. Irreversible cardiogenic shock was characterized by Stage II syndrome of low blood viscosity which was intractable. In acute myocardial infarction without concomitant acute left ventricular failure, rheologic disorders were characterized by Stage I syndrome of high blood viscosity, i. e. they were compensated and did not require intensive rheologic therapy. The management of rheologic impairments attending acute left ventricular failure should be combined, the intensity of therapeutic measures, the nature of combinations and the dosage of drugs being dependent on the degree and phase of rheologic disturbances.