[Pathogenetical peculiarities of the first period of trauma disease in acute heart failure].

Under observation there were 29 casualties with severe combined trauma complicated by acute heart failure (AGF) caused by a direct injury of the heart, without severely disturbed consciousness and valuable blood loss. In 65% of the patients the trauma was severe, in 35%--extremely severe. Higher ST wave was registered in ECG of 40% of the patients in standard leads, in 30% there was no wave R in chest leads. Disturbed rhythm was noted 2-2.5 times more often than in other kinds of injuries. Ventricular extrasystoles, paroxysmal ciliary arrhythmia, atrioventricular and ideoventricular rhythm were determined since the first day after trauma. The results of the investigation have shown that the primary injury of the myocardium was followed by a decreased heart work. Circulatory insufficiency of blood circulation was developed. The impaired systemic hemodynamics led to inadequate delivery of oxygen to the tissues and of oxygen consumption, to the development of tissue hypoxia and respiratory disorders closely connected with it. The circulation disturbances caused also a suppression of detoxication mechanisms of organism, the development of disseminated intravascular coagulation and endotoxicosis.