To reveal and evaluate the severity of concurrent coronary heart disease (CHD) in patients with atherosclerotic aneurysm of the abdominal aorta and to optimize preoperative preparation and intraoperative management, 38 patients underwent comprehensive physical examination, echocardiography, a set of ECG exercise tests. Concurrent CHD was encountered in 87% of cases with abdominal aortic aneurysm. The specific feature of CHD in this aortic abnormality is the predominance of its severe forms as evidenced by findings of coronary circulatory reserve. The incidence of postoperative events is directly related to the reserve of coronary circulation. With all these facts, patients with atherosclerotic aneurysm of the aorta should undergo ECG exercise tests and, depending on the findings, differential antianginal therapy in the preoperative period and nitrate use under the control of central hemodynamics during surgery.

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