It was found that rheumatoid arthritis patients with clinical signs of cardiac involvement showed significant changes of the central and intracardiac hemodynamics that were characterized by suppression of the contractile and pumping function of the left ventricle as compared with patients showing no heart involvement. The authors describe in detail special treatment of RA patients with cardiac involvement.
The article is devoted to the issue of great current interest--that of treatment of patients with acute viral myocarditis. Topicality of the subject in touched upon in some detail, positive and negative sides of use of corticosteroids in patients with acute viral myocarditis are outlined. Comparative data are submitted of treatment of patients with acute viral myocarditis running a grave clinical course with heparin, thiotriasoline, complex heparin--thiotriasoline--prednisolone. The presented results of treatment show expediency of administration of corticosteroids leading to a statistically significant decrease in concentration of titres of antiviral antibodies Coxsackie B1-4 viruses, increase in ejection fraction, rises in platelet count in patients with acute viral myocarditis running a grave clinical course.
For the first time it is established that patients with acute virus myocarditis (AVM) at all stages of severity of clinical course of the disease have changes in indicators of fibrinogens, soluble complexes of monomeric fibrin, products of its degradation, activated plasminogen, time recalcification of blood plasma to blood heparin, fibrinolytic activity of plasma, spontaneous fibrinolysis, time of lysis of euglobulin clot, blood heparin, antithrombin III, platelets. It testifies to suppression of fibrinolysis processes which expressiveness statistically reliably correlates with degree of severity of clinical course of AVM. Application of medicamentous correction is necessary for prevention of the development of disseminated intravascular blood coagulation syndrome.
Acute infectious myocarditis is accompanied by disturbances in the contractile function of the left ventricle, its degree being related to the gravity of the disease course. Improvement in the condition of the left ventricular contractile function correlates both with degree of severity of the illness and methodological approaches to the conducted therapy.
The novelty of the work consists in application of hirudotherapy (leeches) to treat infectious myocarditis, which therapy has been embarked on for the first time in the treatment of this medical condition. Coagulation methods used by the author are modern, the methodical approach is adequate. The role of hirudotherapy versus heparin therapy is shown.