Objective:We present the case of possible reverse type of TCM in a female patient presented with progressive left ventricular dysfunction and its rupture in pericardium.Methods:The detailed history, physical examination, laboratory tests, electrocardiography, serial echocardiography, coronary angiography with left ventriculography were performed to diagnose possible Takotsubo cardiomyopathy in 63-year old woman admitted to our center with complaints of dyspnea, lightheadedness, weakness and signs of hypotension and history of inferior myocardial infarction, acute left ventricular aneurysm, and effusive pericarditis and pleuritis, developed after emotional stress 5 months ago.Results:Clinical evaluation revealed unremarkable laboratory tests, normal troponin values, signs of old inferior myocardial infarction on electrocardiogram, and left ventricular (LV) dilatation and dysfunction, akinesia of LV infero-lateral wall with thinning and its rupture and blood shunting in pericardium. Her coronary angiography revealed normal coronary arteries. The diagnosis of pheochromocytoma was excluded. The patient underwent surgery under cardiopulmonary bypass with removal of LV pseudoaneurysm. The patient was discharged from hospital with improvement in NYHA class and LV function.Conclusion:Thus, in female postmenopausal patients presenting with acute myocardial infarction signs complicated by pericarditis, intact coronary arteries and LV dysfunction with emotional stress as triggering factor, reverse type of TCM should be considered and proper management applied to prevent development of life-threatening complications like LV rupture.

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Objective: The aim of this paper is to understand the structure of congenital heart diseases (CHD) and the age of the first diagnosis in a population referred to specialized cardiac surgery center from different regions of Kyrgyz Republic. Methods: In 2017, 7213 people of different ages, from Kyrgyz Republic were examined by using transthoracic echocardiogram at cardiac surgery center aimed to detection of congenital heart disease Results: In total, 478 new patients with primary diagnosis of CHD were identified; 413 (86%) patients had a delayed diagnosis. The total detectability was 6.75%. The structure of congenital heart disease has a large difference depending on the age group. The proportion of complex heart defects predominates in newborn children and significantly decreases with age. Conclusion: A study of the prevalence and structure of heart defects in the country will help to find the right decision in planned care for patients with CHD, in cases of limited resources.

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In this article, we present preliminary results of screening for congenital heart diseases (CHD) in Kyrgyz Republic. Pilot project for early diagnostics of CHD, launched in this year, shows initial results of screening in remote areas of our country.