Российский национальный исследовательский медицинский университет имени Н. И. Пирогова, москва 2 Городская клиническая больница № 15 имени О. м. Филатова, москва, Россия non-compact myocardium of the left Ventricle in a pregnant patient With inherited thromBophilia: clinical case inVestigation Kokorin V. a. 1 , Kochmareva e. a. 1 , Vardanyan a. g.

Non-compaction of the ventricular myocardium (NCM) is a genetic cardiomyopathy usually due to mutationof the G4.5 gene located in the Xq28 chromosomal region. This congenital disorder is characterized by pronounced trabeculations and intertrabecular recesses resulting from abnormal embryogenesis between the fifth and eighth fetal weeks. The reported prevalence in the general population is between 0.014% and 1.3%. The classic triad of complications includes heart failure, ventricular arrhythmias and systemic embolic events, although some patients have an asymptomatic form. NCM is commonly diagnosed by echocardiography, but contrast ventriculography, CT and MRI can also be used. Here we present a case of left ventricle NCM, manifested after respiratory infection, in a pregnant patient with congenital thrombophilia and a history of myocardial infarction. LEARNING POINTS• Non-compaction myocardium (NCM) in pregnant women has been associated with a poor prognosis.• We should avoid routinely recommending young women with NCM to refuse pregnancy.• A decision to continue pregnancy should be made by the patient in discussion with specialists. KEYWORDS Non-compaction myocardium, pregnancy, heart failure, thrombophilia. CASE REPORTA 26-year-old female patient was admitted to hospital in 2014 with complaints of dyspnoea. The patient had a family history of sudden death (her father), but she herself had shown no signs of cardiovascular disease until 2009. Pregnancies in 2007 and 2008 had ended in miscarriage at 6-8 weeks. Antiphospholipid syndrome was excluded. In 2009, signs of heart failure (shortness of breath, oedema of the legs) and episodes of unsustainable ventricular tachycardia (VT) manifested after respiratory infection and were associated with a reduction in ejection fraction (EF) to 26%. In 2010 the patient had a myocardial infarction of the LV inferior wall and right ventricle (RV), complicated by thrombus formation in the RV. Intact coronary arteries were found on angiography. Embolic genesis of the myocardial infarction was suspected. Genetic testing revealed hereditary thrombophilia with increased sensitivity to warfarin. Echocardiography and MRI were performed and non-compaction myocardium of the LV was observed (Figs. 1 and 2). Following therapy with ACE inhibitors, beta-blockers,

The review presents current data on the prevalence of chronic glomerulonephritis in different regions of the world according to the data of in vivo studies of histology of renal biopsy specimens. The literature data on the significance of glomerulopathies in the development of chronic kidney disease and risk factors of its progression to the terminal stages are reflected. We analyzed data on the most common types of glomerulonephritis – IgA-nephropathy, lupus nephritis on the ratio of primary and secondary forms of glomerulonephritis, their significance in the development of arterial hypertension and cardiovascular complications of this pathology.

Hypertensive disorders in pregnant women are a significant factor in the development of complications leading to maternal and perinatal mortality. However, most cases of adverse outcomes are preventable. The choice of drug therapy in this group of patients should be made on the basis of a complete analysis and risk stratification.Purpose of work. Consideration of modern classification, diagnostic methods and rational antihypertensive therapy of chronic arterial hypertension on the example of a clinical case of a pregnant patient in a therapeutic hospital.Case description. The presented work describes a case of severe arterial hypertension during the first trimester of pregnancy, poorly amenable to drug correction.Conclusion. The features of this clinical observation are the problems associated with the selection of antihypertensive therapy for severe arterial hypertension during low gestational age pregnancy, taking into account comorbidities