A patient with dyspepsia and moderate anemia, without concomitant autoimmune diseases (in particular, thyroid pathology), is presented. An algorithm for diagnosing autoimmune gastritis is demon-strated.

Nervous system tumors are not the most common cancer in the population. However, the clinical manifestations of brain tumors (BTs) are very multifaceted and can mask a wide range of pathologies, which poses a difficult task for doctors to suspect a cancer and start treating the patient as soon as possible. An atypical clinical course of the BTs is described, which caused a rather long path to diagnosis in a middle-aged patient.

The discrepancy between the clinical performance and a specific disease is often encountered in clinical practice and is a rather life-threatening condition and raises many questions about the timely and, more importantly, correct differential diagnosis of the disease, as well as the optimal management and the choice of conservative and/ or surgical treatment. This publication raises issues of etiology for discussion and proposes for consideration the diagnosis and further management of multivessel coronary disease in a middle-aged patient without severe complaints and clinical performance. Timely surgery made it possible to prevent further irreversible consequences for the life and health of the patient.

Polymyalgia rheumatica is a systemic inflammatory disease that is rarely diagnosed in clinical practice due to the low awareness of physicians and the absence of specific diagnostic markers. The case report is of particular interest due to the absence of typical laboratory signs and the presence of concomitant diseases in the patient with similar clinical manifestations. Timely diagnosis and the appointment of adequate therapy made it possible to achieve clinical and laboratory remission without irreversible consequences for the patient’s health.

Diastolic myocardial dysfunction is the most important pathogenetic factor in heart failure and makes a significant contribution to hemodynamic disorders, which leads to a significant deterioration in the quality of life and prognosis of patients. This article presents a case of a patient with hypertrophic cardiomyopathy with paroxysmal atrial fibrillation and repeated pulmonary edema due to impaired diastolic function, a significant increase in mitral regurgitation and pulmonary hypertension. Given the ineffectiveness of antiarrhythmic therapy and the predicted failure of catheter ablation of the arrhythmogenic focus, the patient was scheduled for atrioventricular destruction. However, the strategy was revised to optimize the heart failure therapy, against which the tachysystole paroxysmal atrial fibrillation did not recur over the following time.

Pulmonary hypertension is an extremely rare disease that threatens the life of patients. It is necessary to clearly understand the diagnosis criteria and evaluate the effectiveness of specific therapy. In a case report, an algorithm is described step by step that helps to come to a rare and interesting diagnosis.

Sarcoidosis is a multisystem granulomatosis of unknown etiology, histologically characterized by noncaseating epithelioid cell granulomas in various organs and tissues. In most cases, sarcoidosis affects the lungs, but not only the lungs can be involved. The publication discusses the difficulties of diagnosing and treating both isolated cardiac sarcoidosis and heart damage in systemic sarcoidosis.

In the presented case report, a patient with persistent atrial fibrillation developed due to borreliosis and grade III left atrial spontaneous echo contrast (SEC) according to transesophageal echocardiography, in order to rule out intracardiac thrombosis and concomitant Lyme carditis, contrastenhanced cardiac magnetic resonance imaging was performed. Given the rapid progression of heart failure on the background of tachycardia, the lack of evidence for left atrial appendage thrombosis and myocarditis, electrical cardioversion was performed with the restoration of sinus rhythm and without thromboembolic complications during further follow-up. The issues of the clinical and prognostic significance of SEC, the potential of various diagnostic methods, and the management of such patients are discussed.

Heart failure (HF) is a prognostically unfavorable complication of cardiovascular diseases. The presented case report describes the management of a patient with severe progressive biventricular HF due to myocarditis, refractory to therapy and requiring heart transplantation. Issues of timely diagnosis of HF and the feasibility of radical surgical treatment are discussed.

Hereditary angioedema is a rare (1:50,000) hereditary chronic disease from the group of primary immunodeficiencies, which manifests in the form of recurrent skin and mucous membrane edema of the respiratory tract and gastrointestinal tract.

Pathogenesis of this disease are associated with an increased risk of a number of cardiovascular pathologies, which is associated with the complexity of management and choosing optimal treatment methods. This case report demonstrates the complexity of managing a patient with hereditary angioedema, multifocal atherosclerosis, severe aortic stenosis, and gastric neuroendocrine cancer.

It takes at least several months from the suspicion of amyloidosis to the diagnosis. This delays the start of specific therapy. Diagnosis of amyloidosis should consist not only in the differential diagnosis and confirmation of the diagnosis, but also in determining the type of amyloidosis. The case report is interesting in that paraclinical diagnostics determined the picture characteristic of ATTR-amyloidosis with involvement to the peripheral nervous system and heart, as well as the picture of AL-amyloidosis with predominant renal involvement. For the final diagnosis, repeated biopsy with subsequent amyloid typing was required.

Every day, doctors are faced with severe patients with various diseases, which is aggravated due to comorbidities. However, the management of such patients is complicated due to severe surgical pathologies, the treatment of which involves exclusively surgical intervention. The case describes a patient with critical aortic valve stenosis, hemodynamically significant coronary stenosis, metabolic and hematological disorders, as well as respiratory pathology. In order to achieve an optimal result, the patient’s diabetes therapy was adjusted, specific therapy for secondary erythrocytosis was prescribed, and CPAP therapy for severe sleep apnea was initiated, which made it possible to perform simultaneous stenting of the affected coronary arteries and transcatheter aortic valve implantation.

Coronary angiography is today a routine method for assessing the coronary arteries. However, in practice, invasive cardiologists daily face difficulties in assessing the coronary system. The publication considers the management of an elderly patient with class III angina and a dubious exercise test.

A rare clinical variant of angina manifestation as part of the coronary steal syndrome in a patient with prior bilateral coronary artery bypass grafting and subtotal brachiocephalic trunk stenosis is considered.

The combination of arterial and venous thrombosis is relatively rare in clinical practice, but it is a life-threatening condition and raises many questions for the clinician team about the optimal management and the choice of preferred conservative and/or surgical methods of treatment. The publication raises issues of etiology for discussion and suggests for consideration the management of combined thrombosis of the arterial and venous lower limb systems in a middle-aged patient without risk factors predisposing to thrombosis. The combination of optimal anticoagulant therapy, optimal terms and scope of conservative treatment and minimally invasive interventional arterial revascularization made it possible to restore viability and preserve the lower limb and its functional status in full without unfavorable consequences for the patient’s health.

Chronic lower limb ischemia is becoming increasingly common among patients worldwide. This is a comorbid condition, which is accompanied by chronic pain, trophic ulcers and gangrene, as well as a decrease in the quality of life. Despite the chronic nature of ischemia, the absence of treatment is accompanied by a high rate of limb amputation and mortality. It has been proven that in patients with peripheral arterial disease of the lower extremities, the risk of cardiovascular events and mortality increases. The publication proposes to consider the tactics of minimally invasive arterial revascularization in a patient with occlusive restenosis of the right superficial femoral artery. The correct choice of minimally invasive surgical treatment in combination with a complex of both non-drug (walking) and drug methods made it possible to restore viability and preserve the lower limb without unfavorable consequences for the patient’s health.