Cardiac Dyssynchrony as A Component of Decompensation in Chronic Heart Failure In The Presence Of Multiple Comorbidities: A Clinical Case
DOI:
https://doi.org/10.37547/ijmscr/Volume06Issue01-05Keywords:
chronic heart failure, ischemic cardiomyopathy, sacubitril/valsartanAbstract
This paper presents a clinical case of a female patient with chronic heart failure with reduced ejection fraction (HFrEF, LVEF 28%) caused by ischemic cardiomyopathy and complete left bundle branch block (LBBB). The clinical course was complicated by arrhythmias, hypothyroidism, arterial hypertension, and signs of systemic congestion. Despite pronounced polymorbidity, temporary clinical stabilization was achieved using comprehensive guideline-directed medical therapy, including sacubitril/valsartan, β-blockers, mineralocorticoid receptor antagonists (MRAs), and SGLT2 inhibitors.
The patient objectively met all established criteria for cardiac resynchronization therapy (CRT). This case highlights the importance of a personalized, multidisciplinary approach and timely consideration of invasive treatment strategies. It also illustrates the complexity of managing chronic heart failure in patients with multiple comorbid conditions.
References
McDonagh T.A., Metra M., Adamo M., et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Heart Journal. 2021;42(36):3599–3726.
Mareev V.Yu., Fomin I.V., Ageeva F.T., et al.
Chronic heart failure: National clinical guidelines. Kardiologiia. 2020;60(6):4–101. (In Russian)
Oganov R.G., Lebedev D.S., Shlyakhto E.V.
Cardiovascular diseases in Russia: epidemiology and strategy. Cardiovascular Therapy and Prevention. 2021;20(3):5–11. (In Russian)
Heidenreich P.A., Bozkurt B., Aguilar D., et al.
AHA/ACC/HFSA Guideline for the management of heart failure. Journal of the American College of Cardiology. 2022;79(17):e263–e421.
Ponikowski P., Voors A.A., Anker S.D., et al.
ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Heart Journal. 2016;37(27):2129–2200.
Kolesnikov A.I., Smirnov P.A. Cardiac resynchronization therapy: indications and limitations.
Russian Journal of Cardiology. 2019;24(2):37–44. (In Russian)
Brignole M., Auricchio A., Baron-Esquivias G., et al. 2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy. European Heart Journal. 2013;34(29):2281–2329.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Akhmatov Ya.R, Norkulov M.S., Irisov J.B., Kuziev F.A., Mirzaev B.S.
This work is licensed under a Creative Commons Attribution 4.0 International License.
