The need for otolaryngological screening in patients with chronic heart failure: study data

Objective: To assess the prevalence of chronic tonsillitis (CT) in elderly patients with cardiovascular pathology and chronic heart failure (CHF), and to identify clinical features and diagnostic challenges of comorbid conditions.

Materials and Methods: A retrospective clinical study was conducted, involving 443 patients aged 55–79 with diagnosed cardiovascular diseases and signs of CHF, who were hospitalized at Pokrovskaya City Hospital and the Peter the Great Hospital of the North-Western State Medical University named after I.I. Mechnikov between 2016 and 2020. The examination included an otorhinolaryngological assessment, patient complaint survey, analysis of medical history, frequency of exacerbations, and clinical signs of CT based on I.B. Soldatov’s 1975 classification. CHF was diagnosed according to the 2017 national guidelines using the 6-minute walk test and echocardiography (ECHO).

Results: Chronic tonsillitis was diagnosed in 84 patients (19%) with CHF, mainly in a compensated form. In 80% of cases, the disease had an onset in childhood. Most patients experienced the disease without frequent episodes of angina and with rare exacerbations. Despite typical signs of CT observed during physical examination, only 5% of patients had previously consulted an ENT specialist. Nonspecific complaints, mostly related to general intoxication symptoms, complicated timely diagnosis. Common pharyngoscopic findings included hyperemia of the palatine arches, cicatricial changes, and caseous plugs in the tonsillar crypts.

Conclusions: Chronic tonsillitis is a prevalent comorbid condition among elderly patients with cardiovascular diseases, including CHF. In most cases, it presents with minimal symptoms, making diagnosis difficult and leading to suboptimal treatment strategies. It is recommended to include otorhinolaryngological assessment in the routine diagnostic algorithm for this patient category to enable timely detection and treatment of CT, thereby improving overall prognosis and quality of life.