Management tactics of a young patient with dilated cardiomyopathy complicated by chronic cardiac insufficiency (clinical case)

   Chronic heart failure (CHF) is one of the most common, rapidly progressive diseases of the cardiovascular system with the most unfavorable prognosis in many countries. In the world, approximately 2 % of the adult population suffer from heart failure; in most cases, these are people over 70 years old and approximately half of them have a left ventricular ejection fraction (LVEF) of less than 50% [1; 2]. According to the results of large epidemiological and randomized studies, one-year mortality in this population remains high, reaching 60% among patients with functional classes III-IV (FC). According to various data, from 1 to 4% of cases of emergency hospitalization among adults occur due to heart failure and, undoubtedly, in each case, an underestimation of the condition is possible due to difficulties in diagnosis [3; 4]. Dilated cardiomyopathy (DCMP) is one of the diseases that leads to severe forms of heart failure; it can be asymptomatic for a long time, despite the presence of objective (echocardiographic) signs of ventricular dilation and impaired function [9]. Most often, the first clinical manifestations of the disease are associated with cardiac decompensation, stagnation of blood in the small and then in the large circulatory circles and a decrease in cardiac output [10; 11]. This report describes a clinical case of declatational cardiomyopathy in a 39-year-old young patient. Observation of repeated recurrences of circulatory insufficiency, complexity of diagnostic search.

1. Bokerija L. A., Neminushhij N. M., Postol A. S. Kardial'naja resinhronizirujushhaja terapija. Formirovanie pokazanij i sovremennye podhody k povysheniju jeffektivnosti metoda // Kompleksnye problemy kardial'nyh sosudistyh zabolevanij. 2018. № 3. S. 102 - 116

2. Berkinbaev S. F., Dzhunusbekova G. A., Isabekova A. H., Musagalieva A. T., Koshumbaeva K. M., i dr. Novye vozmozhnosti v terapii ostroj i hronicheskoj serdechnoj nedostatochnosti (itogi issledovanija "Kryl'ja", Respublika Kazahstan) // Kardiologija i serdechno-sosudistaja hirurgija. Vypusk № 2. 2014. - S. 52-58

3. Raatikainen M. J., Arnar D. O., Merkely B., Nielsen J. C., Hindricks G., Heidbuchel H., Camm J. Devices and Interventional Electrophysiological Procedures in the European Society of Cardiology Countries: 2017 Report from the European Heart Rhythm Association // Europace. - 2017. - № 19. - Р. 111 - 190.

4. Raatikainen M. J. Pekka, Arnar D. O., et al. A Decade of Information on the Use of Cardiac Implantable Electronic Devices and Interventional Electrophysiological Procedures in the European Society of Cardiology Countries: 2017 Report from the European Heart Rhythm Association. - Boston, 2017. - P. 148.

5. Fomin I.V. Jepidemiologija hronicheskoj serdechnoj nedostatochnosti v Rossijskoj Federacii. / V kn. Hronicheskaja serdechnaja nedostatochnost' Ageev F. T. i soavt. / M.: GJeOTAR-Media. - 2010. - S. 7 - 77.

6. Klinicheskie rekomendacii. Hronicheskaja serdechnaja nedostatochnost' / Rossijskoe kardiologicheskoe obshhestvo. Nacional'noe obshhestvo specialistov po zabolevanijam miokarda i serdechnoj nedostatochnosti. Obshhestvo specialistov po serdechnoj nedostatochnosti. 2019. - 137 s.

7. Klinicheskie rekomendacii po provedeniju jelektrofiziologicheskih issledovanij, kateternoj abljacii i primeneniju implantiruemyh antiaritmicheskih ustrojstv / Vserossijskoe nauch. o-vo specialistov po klinicheskoj jelektrofiziologii, aritmologii i kardiostimuljacii (VNOA); (razrab.: Revishvili A. Sh. i dr.). - Moskva, 2017. - 702 s.

8. Jurchenko I. V., Sabyrov G. S., Abdil'dina Z. Zh., Sabyrbaeva R. A., Sejsenbaeva G. T., Bajmukanova K. H., Kul'manbetova F. K., Zhabdykbaj N. Zh., Taubaeva A. A., Alieva Zh. N., Kazakova G. N. Zdorov'e naselenija Respubliki Kazahstan i dejatel'nost' organizacij zdravoohranenija v 2018 godu // Statisticheskij sbornik. - Nur-Sultan, 2019. - S. 324.

9. Pluess M., Daeubler G., Dos Remedios C. G., et al. Adaptations of cytoarchitecture in human dilated cardiomyopathy // Biophys. Rev. - 2015.- № 7. - Р. 25-32.

10. Stolfo D., Merlo M., Pinamonti B., et al. Early improvement of functional mitral regurgitation in patients with idiopathic dilated cardiomyopathy // Am. J. Cardiol. - 2015. - Vol. 115, № 8. - Р. 1137-1143.

11. Theresa A. McDonagh, et al., 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) With the special contribution of the Heart Failure Association (HFA) of the ESC, European Heart Journal, 2021; ehab368, https://doi.org/10.1093/eurheartj/ehab368.