No abstract

Out of all the cardiac manifestations of post-COVID syndrome, tachycardia has been studied to a lesser extent, while almost all patients complain of palpitations.The purpose of the study is to reveal the incidence of post-COVID tachycardia syndrome in apparently healthy patients and to evaluate the effectiveness of ivabradine in this category of patients.Materials and methods. 48 patients revealing no comorbid pathology were examined 12 or more weeks after COVID-19. Materials of instrumental research methods, functional tests, quality of life before and during treatment with ivabradine were studied.Results. In all patients included in the study, against the background of an autonomic imbalance with a predominance of the activity of the sympathetic part and deterioration in quality of life, the syndrome of post-COVID tachycardia was diagnosed, and a positive effect of ivabradine on heart rate control was revealed.Conclusion. Tachycardia can be considered a marker of post-COVID syndrome in patients who were apparently healthy before coronavirus infection; it can manifest itself in POTS, NST, or their combination, as well as be accompanied by other cardiac arrhythmias including PVC, SVE, non-sustained SVT, and persistent form of AF. Ivabradine is able to control heart rate and level the manifestations of post-COVID tachycardia syndrome.

The pandemic of a new coronavirus infection caused the need to reorganize the work of emergency medical services (EMS) due to the high contagiousness and mortality, multiple organ lesions, difficulties in diagnosis and the lack of protocols for providing medical care to patients at the prehospital stage.The purpose and objectives of the study is to assess the activities of the ambulance service in the context of a new coronavirus infection in Krasnodar.Materials and methods: data of the information base of the integrated automated system for managing the activities of the ambulance station SBIHC KEH of the Ministry of Health Care of the Krasnodar Region in Krasnodar.Results. А differentiated approach and algorithm was developed for assessing the severity of the condition in patients with COVID-infection and ARVI, their routing and organization of treatment in Krasnodar.Conclusion: an assessment of the work of the ambulance service in combination with the measures taken during the observation period will ultimately allow organizing high-quality medical care to the population.

Introduction. Hemostasis disorders presented in the form of thrombosis in various vascular territories are one of the main causes of death against the background of COVID-19. Their threat persists even after recovery as part of the post-COVID syndrome. Recent studies demonstrate that the development of thromboin-flammatory syndrome is possible not only in the lungs. At the same time, the frequency of revealed venous thrombosis is 10–35% and 60% according to autopsy data. One of the localizations of venous thrombosis in COVID-19 may be the portal system. Portal vein thrombosis is a rarely diagnosed disease that remains asymptomatic for a long period, which makes its timely diagnosis difficult. At the same time, the prognosis for PVT is mostly unfavorable with deaths occurring in half of the cases.The purpose of the study is to demonstrate the features of diagnosis and treatment of PVT on the example of a clinical case in a patient who had a mild coronavirus infection.Description of clinical case. The article describes a clinical case of diagnosis and successful treatment of extended thrombosis of the portal, splenic and superior mesenteric veins against the background of direct anticoagulant therapy and thrombolysis by means of the percutaneous transhepatic portal access. The disease in patient K.V.A., 49 years old who had a moderate coronavirus infection (liver disease and congenital thrombophilia as a cause of thrombosis are excluded) was complicated by spleen infarcts, hydroperitoneum, partial small bowel obstruction.Conclusion. This clinical case is of interest for the possibility of a successful combination of anticoagulant and regional thrombolytic therapy without surgical intervention in complicated thrombosis of the portal vein and its tributaries in a patient in the post-COVID period, and also dictates the need for a personalized approach to the duration and choice of doses of anticoagulant therapy after a COVID-19 infection.

АННОТАЦИЯ Цель. Ознакомить врачей практического здравоохранения с клиническими проявлениями, современными методами диагностики и тактики лечения пациентов с редким наследственным сосудистым заболеванием, преимущественно поражающим сосуды нижних конечностей-синдромом Клиппеля-Треноне. Материалы и методы. Проведен ретроспективный анализ анамнестических данных, течения заболевания, результатов лабораторных и инструментальных исследований, определена тактика лечения пациентов. Результаты. Синдром Клиппеля-Треноне является разновидностью системных наследственных флебоангиодисплазий. Аномалия диагностируется сразу при рождении на основании знания клинических симптомов или в ходе развития ребенка, когда становятся более очевидными типичные проявления заболевания. Своевременно проведенные инструментальные исследования позволяют оценить степень тяжести поражения сосудистого русла, уточнить наличие сопутствующих аномалий с целью выбора эффективного метода лечения, дифференцировать тип варикозной трансформации вен нижних конечностей, предотвратить необоснованную флебэктомию, влекущую необратимые последствия. Заключение. Знание клинических проявлений, дифференциальная диагностика и своевременный выбор тактики ведения больных с синдромом Клиппеля-Треноне приобретают особое значение для врачей всех уровней оказания медицинской помощи с целью сохранения качества жизни.