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Ключевые моменты рекомендаций ACC/AHA/HRS 2017 по диагностике и лечению обмороков

https://doi.org/10.18087/cardio.2018.8.10151

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Аннотация

В статье обсуждаются новые Клинические рекомендации Американской коллегии кардиологов, Американской кардиологической ассоциации и Общества по изучению сердечного ритма (ACC/AHA/HRS) по диагностике и лечению обмороков, опубликованные в марте 2017 г. Обобщая и анализируя доказательную базу и накопленный опыт, Рекомендации ACC/AHA/HRS отражают дальнейшее развитие проблемы диагностики и лечения пациентов с обмороками. Традиционно в основе диагностического алгоритма обмороков лежит первичное обследование, и в Рекомендациях прослеживается усиление значимости анамнестических критериев, дополнены ЭКГ-критерии аритмических обмороков. В то же время пересматривается диагностическая ценность провокационных тестов, следствием чего стал более низкий для них класс показаний. Наряду с диагностикой причины обморока, согласно Рекомендациям, ключевое значение имеет стратификация риска кратко- и долгосрочных неблагоприятных исходов. В Рекомендациях суммированы последние достижения в лечении обмороков при саркоидозе, аритмогенной дисплазии правого желудочка, первичных аритмических заболеваниях сердца, ортостатической гипотонии, рефлекторных обмороков. Будучи ориентированными на особенности оказания медицинской помощи в Америке, Рекомендации могут быть полезны практикующим врачам в выборе наилучшей стратегии диагностики и лечения обморока в каждом индивидуальном случае.

Об авторах

Г. А. Головина
ГБУЗ «НИИ - Краевая клиническая больница № 1 им. проф. С. В. Очаповского» Минздрава Краснодарского края
Россия


Д. В. Дупляков
ГБУЗ «Самарский областной клинический кардиологический диспансер» Минздрава России; ФГБОУ ВО «Самарский государственный медицинский университет» Минздрава России
Россия


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Для цитирования:


Головина Г.А., Дупляков Д.В. Ключевые моменты рекомендаций ACC/AHA/HRS 2017 по диагностике и лечению обмороков. Кардиология. 2018;58(8):89-100. https://doi.org/10.18087/cardio.2018.8.10151

For citation:


Golovina G.A., Duplyakov D.V. Key Points of the 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope. Kardiologiia. 2018;58(8):89-100. (In Russ.) https://doi.org/10.18087/cardio.2018.8.10151

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