No abstract

The article is devoted to the risk of cardiovascular disease in coronavirus infection. In March 2020, the World Health Organization announced the COVID-19 pandemic. The virus set many tasks for practicing doctors, including the study of its pathogenesis and the creation of a therapy suitable for all patient groups. This paper presents information about cellular entry of the coronavirus, the development of cardiovascular diseases, in particular, the heart, and the latest data on experimental therapy with hydroxychloroquine. Coronavirus has been shown to affect the synthesis of angiotensin 2, which increase the QT interval. At the same time, the combination therapy using chloroquine and azithromycin caused a critical prolongation of the QT interval in some cases. On 4 July 2020, WHO accepted the Solidarity Trials International Steering Committee recommendation has stop the trial of these drugs. Cardiologists should review the latest information on the effects of coronavirus on the cardiovascular system and based on this, make recommendations the management and treatment of severe patients.

The manual contains new knowledge on the diagnosis of diseases of internal organs from the position of a thorough, systematic study of the skin. Includes a large illustrative material that provides a visual perception of therapeutic diseases in fact at a glance at the patient. Compiled in accordance with the working program of the discipline "Propaedeutics of internal diseases". Meets the requirements of the Federal state educational standards of higher education of the last generation. For students of medical universities implementing educational programs in the areas of training 31.05.01 "Medical business", 31.05.02 "Pediatrics", 32.05.01 "Medical-preventive business".

Background. Multimorbidity is a specific characteristic of the modern patient with chronic heart failure (CHF) which significantly changes clinical course, prognosis of the syndrome, leads to socio‑economic losses and makes significant adjustments to treatment tactics. The goal is to study the clinical features and prognosis of patients with CHF in combination with chronic obstructive pulmonary disease (COPD). Materials and methods. We studied 183 HF patients, including with stable CHF, including 105 with CHF combined with COPD. The clinical phenotype was assessed by its belonging to the functional class and the severity of COPD. A 6‑minute walk test (6‑MWT), spirometry, echocardioscopy, testing on a scale assessing the clinical condition, quality of life were studied. The end points during the year were: all‑cause mortality and cardiovascular mortality, myocardial infarction, stroke, pulmonary embolism, and hospitalization rates due to acute decompensation of CHF. Results. The clinical phenotype of CHF combined with COPD was characterized by a high frequency of smoking, low quality of life and exercise tolerance. Respiratory dysfunction in CHF in combination with COPD was characterized by mixed disorders (68.4%), in CHF without lung disease, restrictive (25.6%). Cardiovascular mortality in comorbid pathology was 4.0%, in CHF without COPD – 4.6%; myocardial infarction was observed 1.7 times more often with lung disease than in patients with CHF only (16.8% and 10.8%); stroke was observed exclusively in comorbid pathology (8.9%). The combined endpoint (all cardiovascular events) with CHF in combination with COPD was achieved 2.3 times more often in comparison with patients with COPD only (29.7% and 15.4%). Hospitalization due to acute decompensation of CHF occurred 2 times more often with CHF in combination with COPD than without it (32.7% and 15.4%) with a tendency to increase as the left ventricular ejection fraction decreased. Conclusion. The results of the study demonstrate that COPD contributes to the formation of the clinical phenotype of CHF from the standpoint of the mutual influence of the characteristics of the cardiovascular and respiratory systems, and also aggravates the prognosis that requires an integrated approach to the differential diagnosis and individualization of pharmacotherapy.