Management of a patient with dyspnea on an outpatient admission

Background. Management of patients with dyspnea syndrome remains complicated in terms of diagnostics and treatment in outpatient conditions. Aim. To present a summary of contemporary view of diagnostic search directions, differential diagnosis in dyspnea syndrome as well as of the main points of therapeutic approach with the focus on diuretics use. Materials and methods. We systematized materials from Russian and foreign publications (PubMed, eLIBRARY and other) for the past 2–15 years as well as present clinical recommendations and guidelines, and provided citations and beliefs of Russian medicine classics about the discussed phenomena in order to write this review. Results. The diagnostic approach in dyspnea syndrome is based in analysis of anamnestic, objective, laboratory and instrumental data and requires from the medical practitioner a scrupulous analytic approach to identify the cause of the disorder and to manage it prescribing pathogenic therapy on time. Diuretics use remains one of the basic approaches to pathogenic therapy. Conclusion. Management of a patient with dyspnea in outpatient conditions remains challenging. It is an interdisciplinary issue that is not completely worked out in terms of diagnostics and treatment and requires fundamental knowledge and awareness of modern approaches to diagnostics and treatment of major disorders characterized with dyspnea syndrome

Statin therapy in patients with high and very high cardiovascular risk: an optimal approach

This article discusses the problems of adequate therapy for dys-lipidemia in patients with high and very high cardiovascular risk in clinical practice. Updated Russian and European guidelines for the treatment of dyslipidemia pick out five categories of cardiovascular risk and clarify goals of prevention and treatment of atherosclerosis. The data of most significant clinical studies on rosuvastatin, highlighting its high lipid-lowering efficacy, the effect on the progression of atherosclerosis and the prognosis in patients with cardiovascular disease, are presented