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Pancreas in atherosclerosis and myocardial infarction
Last reviewed: 04.07.2025
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Damage to the pancreas in atherosclerosis and myocardial infarction
Causes, pathogenesis. Damage to the pancreas in atherosclerosis is observed mainly in people over 60 years of age, less often and at a younger age - mainly in people suffering from alcoholism. In this case, sclerotic changes develop in the pancreas, its excretory and endocrine functions are disrupted. The latter is often the cause of so-called senile diabetes. However, there is also an opinion in the literature that vascular lesions of the pancreas relatively rarely cause consequences such as inflammatory changes, since it has a well-developed network of collaterals.
In contrast to this opinion, some scientists and clinicians believe that the pancreas is very sensitive to circulatory disorders in it, despite its fairly well-developed vascular network. However, blockage of one or more vessels causes only focal ischemic and necrotic changes, and not a picture of diffuse pancreatic necrosis. Hemorrhages of the diapedesis type are quite common - with severe flu, a number of infectious diseases, allergic reactions, accidental overdose of anticoagulants, etc.
Pancreatic lesions are observed in acute myocardial infarction: in mild cases they are functional in nature and manifest only by mild pain in the left hypochondrium and disturbances in the excretory and endocrine functions of the pancreas; less often, myocardial infarction is accompanied by acute (in some cases hemorrhagic) pancreatitis, and in some cases acute thrombosis of the pancreatic vessels occurs with a clinical picture of acute hemorrhagic pancreatitis.
Compression of the celiac artery, vasculitis and, possibly, severe episodes of arterial hypotension can also lead to the development of acute hemorrhagic pancreatitis.
Symptoms, diagnostics. It is difficult to establish a correct diagnosis for various circulatory disorders in the pancreas, and it is possible, basically, only hypothetically: if, against the background of diseases in which circulatory disorders in the pancreas are observed, acute pancreatitis suddenly, without any particular reason, occurs or diabetes mellitus gradually develops. The diagnosis is confirmed by ultrasound of the pancreas and a study of the activity of its enzymes in the blood and urine, and if the patient's condition allows - and in the duodenal contents.
Treatment. In the first hours and days - treatment as in acute pancreatitis and diabetes mellitus. It is also necessary to treat the underlying process (heart failure, atherosclerosis, etc.). Subsequently, with a favorable outcome, as a rule, functional pancreatic insufficiency and chronic pancreatitis develop. Treatment for exocrine pancreatic insufficiency is carried out with a diet (as in chronic pancreatitis), frequent fractional meals and pancreatic enzyme preparations (panzinorm, pancitrate, festal, pancreatin, etc.) in the required dose.
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