[Prinzmetal angina. Questions of pathogenesis, clinic, diagnosis and treatment].

Current problems of Prinzmetal angina (vasospastic angina, variant angina) considers in this review. Attention is drawn to early diagnosis, which should be comprehensive, taking into account possible atypical courses and the development of complications. The important role of electrocardiographic monitoring (including using implantable recorders) is highlighted. It is emphasized that patients with cardiac arrhythmias, syncope are at high risk of developing sudden cardiac death. In this category of patients, it is recommended to timely determine the indications for implantation of a cardioverter - defibrillator. Authors consider the prospects of using new methods of treatment of angina pectoris.

[Innovative methods-of treatment of cardiac patients in amultidisciplinary hospital].

The article is a report on the conference "Innovative methods of treatment of cardiac patients in a multi-hospital", which took place at the 3rd Central Military Clinical Hospital n.a. A.A. Vishnevskiy and dedicated to the 40th anniversary of the cardiology hospital center. The reports covered achievements, the latest developments introduced into the practice of medical and diagnostic work of the hospital and its affiliates with patients of cardiovascular profile. The advantages of a multidisciplinary hospital in the provision of specialized high-tech medical care difficult, multimorbid patients are showed. To report the possibility of co-temporal methods of effective treatment of a variety of cardiovascular morbidity in military personnel.

[Myocardial infarction in young population].

Description of clinical observation and literature review. Myocardial infarction in patients younger than 45 years is rare, but it is an important clinical, organizational and psychological problem. A case of myocardial infarction in 19-years old patient, who suffered since 6 years from kidney disease, is described. Transmural left-ventricular myocardial infarction has developed on the background of chronic glomerulonephritis, excessive exercise, and traditional risk factors for cardiovascular disease. Coronary venous bypass with the benefit-pleasing outcome is performed. When analysing the literature, the authors emphasize that in comparison with elderly patients, young people have different profiles of risk factors, clinical manfestations and prognosis of myocardial infarction. It is emphasized that kidney chronic disease, regardless the stage, worsen short-term and long-term outcomes of cardiovascular disease. Early stabilization is possible under the condition of risk stratification and-early revascularization, which leads to better clinical outcomes. Particular attention should be given to a comprehensive assessment, it prognostic criteria, risk factor modification, secondary prevention of major and associated diseases, clinical- and -dynamic observation, including patients with asymptomatic course of the disease.

[A case of adenovirus infection complicated by gram-negative polymicrobial sepsis: A clinical and morphological observation].

Among respiratory infections, adenovirus infection (ADVI), in the presence of which there may be severe pneumonia that frequently results in a fatal outcome, occupies particular attention. ADVI in patients without immunodeficiency is usually mild and shows a limited extent of injury. At the same time the disease in immunocompromised individuals may be severe, presenting with viremia, evolving sepsis, and high death rates. The paper gives a characteristic example of severe ADVI and its fatal outcome.

[Myocardial revasculization in patients with ischemic heart disease and the end-stage of chronic kidney disease].

Chronic kidney disease (CKD) is independent factor of progression of ischemic heart disease (IHD). In that case, it is important to know the peculiarities of diagnosis and treatment of IHD in patients with CKD. The importance of this problem is increasing due to increase of patients with CKD. Cardio-vascular morbidity in patients with CKD is higher than in patients with other diseases. Myocardial revasculization may lead to significant improvement of survivability in patients with CKD. Among the prevention and treatment facilities the Vishnevsky Central Military Clinical Hospital N 3 is a leader in preforming the myocardial revasculization. The authors gave an example of successful coronary artery bypass surgery in patient with IHD and end-stage of CKD. Development of modem medical technologies, systematization of experience and knowledge allow in XXI century to consider CKD as non-absolute contradiction to elective surgery in case of different forms of IHD, including the end-stage of CKD (dialysis treatment). It is advisable to perform the myocardial revasculization in patients with the end-stage of CKD in specialized multi-field hospital, where can provided not only cardiosurgical and cardiological treatment but also specialized treatment for neurological patients, including haemodialysis and hemofiltration.

[35-year practice of treatment of acute coronary syndrome in 3rd central military clinical hospital n. a. A.A.Vishnevsky].

Results of 35-years clinical investigation on acute coronary syndrome performed in the 3rd Central military clinical hospital named after A.A. Vishnevsky are presented. Research topics are the following: pathways of blood coagulation alterations,lipid metabolism, improving drug management of ischemic heart disease exacerbations, new medical technologies in diagnostics and treatment of acute coronary syndrome. Decision procedure in patient with acute coronary syndrome was developed in the Hospital. Criteria for percutaneous coronary interventions and coronary artery bypass surgery were elaborated. Original scale for death and cardiac complications risk assessment in patients with acute myocardial infarction undergoing coronary artery stenting was developed. According to the scale, differential scheme of antiplatelet therapy was introduced, and its implementation resulted in decrease of complications rate. Advantage of early invasive strategy vs. conservative approach was proven.