[Atrial septal aneurysm: Evolution of diagnostic and clinical judgements]. / Anevrizma mezhpredserdnoi peregorodki: évoliutsiia diagnosticheskikh i klinicheskikh predstavlenii.

The article discusses anatomical and clinical judgements on atrial septal aneurysm (ASA) as a primary cardiac structural abnormality. It presents current approaches to the classification of ASA and its echocardiographic diagnosis. Special attention is focused on the clinical significance of ASA as an isolated anomaly and concurrent with other structural abnormalities of the heart, especially from the standpoint of a risk of cardioembolic stroke.

[Chronic obstructive pulmonary disease and coronary heart disease: approaches to the treatment of combined pathology].

This review concerns peculiarities of pharmacotherapy for patients with concomitant coronary heart disease and chronic obstructive pulmonary disease. It describes the main pharmacodynamic and pharmacokinetic properties of cholinolytics, beta-agonists, methylxanthines, corticosteroids, antibiotics, ACE inhibitors, calcium channel blockers, beta-blockers, nitrates, and anti-aggregants. These data are used to substantiate the application of these drugs to the treatment of overlapping pathologies with special reference to concomitant coronary heart disease and chronic obstructive pulmonary disease.

[The role of respiratory infection in exacerbation of chronic obstructive pulmonary disease].

Periods of acute deterioration known as exacerbations significantly lower the quality of life and health status of patients with chronic obstructive pulmonary disease (COPD), thus making treatment of these patients more expensive. Understanding of the pathogenesis of COPD exacerbations and their influence on the clinical course and prognosis of this disease has greatly improved during the last decades. Some aspects of the interrelation between the infectious pathogen and the host organism have been studied. According to modern data, respiratory infections present one of the main causes of exacerbations of the disease. The role of respiratory viruses, especially rhinoviruses and respiratory syncytial virus, which often precede secondary bacterial infections, have been found to be important in the etiology of COPD exacerbation. The main bacterial etio-pathogens of COPD exacerbations--the non-capsulated bacteria H. influenzae, S. pneumoniae, and M. catarrhalis, which in 25 to 50% of cases colonize the lower respiratory tract (LRT)--have been isolated. Colonization of the LRT of infectious agents (viruses and bacteria) results in chronization of the inflammatory process and progress of the disease. Besides, colonization correlates with the severity of the disease. A "vicious circle" theory has been put forward to explain the pathogenesis of COPD exacerbations. Etiological diagnostics of a COPD exacerbation will allow adequate choice of effective etiotropic therapy making it possible to eradicate the pathogen or lower microbial load in the respiratory tract, which will decrease the risk of recurrence and improve the prognosis of the disease.

[Causes and risk factors for development of mitral valve prolapse]. / Predposylki i prichinnye faktory razvitiia prolapsa mitral'nogo klapana.

Mitral prolapse is a common valvular anomaly. Mechanisms of prolapse formation are studied with the use of modern investigation methods. Primary prolapse results from congenital structural defects of intracardiac formations (papillary muscles, trabecules, chordae) of the left ventricle, as well as associated microcirculatory disorders. Genetically caused rearrangement of fibrillar structures of the extracellular matrix of connective tissue (myxomatous degeneration) is observed in half of the patients with primary mitral prolapse. Concerning secondary prolapse of the leaflets, some mechanisms are singled out and a large group of diseases is described.

[Minor heart defects]. / Malye anomalii serdtsa.

Minor anomalies of the heart are morphological changes of the structure and cause functional cardiovascular disorders. Polyorganic disorders and phenotype are indicated typical for congenital defects of the connective tissue. The opinions on mechanisms of development of pathological symptom complexes in minor anomalies of the heart vary. Further studies are necessary.