New-onset pulmonary tuberculosis in a patient with chronic obstructive pulmonary disease and coronary artery disease, angina pectoris: treatment options

Background. The importance of timely diagnosis of new-onset pulmonary tuberculosis (TB) in modern clinical practice is beyond doubt. Chronic obstructive pulmonary disease (COPD) and stable coronary artery disease (CAD, angina pectoris) mutually aggravate each other and worsen the patient’s condition, negatively affecting the prognosis. Description of the clinical case. The objective of the analysis of this clinical case included evaluation of the features of clinical manifestations, diagnostic tests and therapy in a patient with new-onset pulmonary TB and comorbid pulmonary-cardiac pathology: COPD and stable coronary artery disease (angina pectoris). In this clinical case, the patient had a combination of COPD and stable coronary artery disease (angina pectoris), and was also diagnosed with new-onset TB. The patient had general symptoms characteristic of TB, COPD and stable coronary artery disease (angina pectoris), characteristic changes in the results of laboratory and instrumental diagnostic methods. Treatment of new-onset TB was conducted according to regimen I at the settings of Clinical TB Dispensary. The patient took combined bronchodilator drugs: LAMA + LABA (tiotropium bromide/olodaterol); anti-ischemic therapy: non- dihydropyridine calcium antagonists (NDCA, verapamil) and trimetazidine. Conclusion. Against the background of anti-ischemic therapy with the use of NDCA and a myocardial cytoprotector (trimetazidine), the minimization of attacks of retrosternal pain with a sufficient rhythm-reducing effect was achieved.

newly diagnosed pulmonary tuberculosis, chronic obstructive pulmonary disease, stable coronary artery disease, angina pectoris, comorbid pathology