Experience of a multidisciplinary approach to the treatment of comorbid pathology patient


DOI: https://dx.doi.org/10.18565/therapy.2023.8.98-106

Vladimirova N.N., Myasnikova E.V., Shunaev V.M., Komleva G.A., Pikunova I.N., Peredelkina A.I.

Central Clinical Hospital with Outpatient Department of the Administration of the President of the Russian Federation, Moscow
Abstract. Currently, due to the increasing life expectancy of the population and the aging of the population, an increase in the number of comorbid patients with ≥2 pathologies is observed in clinical practice. The presence of mutually aggravating diseases, chronic clinical course and specific manifestations of most of them complicate making diagnosis, adjusting further tactics for patient’s management and drug therapy selection. Article presents the history of the disease of an 88-year-old female patient who was urgently hospitalized with clinical manifestations of gastric bleeding from a newly diagnosed acute ulcer, development of severe posthemorrhagic anemia, complicated by acute anterior widespread myocardial infarction (type 2 according to ESC). The severity of her condition was aggravated by the long course of type 2 diabetes mellitus, diabetic polyneuropathy, angiopathy, and nephropathy. The complexity of diagnostic search, multidisciplinary approach to the management of a comorbid patient, teamwork of highly specialized specialists with the formation of a common opinion, as well as the development of treatment tactics with careful compliance to the requirements of rational pharmacotherapy are described.
Keywords: hemic hypoxia, gastric bleeding, Beers criteria, program hemodialysis, multidisciplinary approach, posthemorrhagic anemia, comorbidity, acute renal failure, Charlson Index
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About the Autors

Nadezhda N. Vladimirova, PhD in Medical Sciences, cardiologist, Deputy chief physician for therapy of Central Clinical Hospital with Polyclinic of the Administration of the President of the Russian Federation. Address: 121359, Moscow, 15 Marshala Timoshenko St.
E-mail: glavchp@cchp.ru
Elena V. Myasnikova, therapist, head of the Department of Therapy No. 2 of Central Clinical Hospital with Polyclinic of the Administration of the President of the Russian Federation. Address: 121359, Moscow, 15 Marshala Timoshenko St.
E-mail: dr.myasnikova@mail.ru
Valentin M. Shunaev, therapist at Central Clinical Hospital with Polyclinic of the Administration of the President of the Russian Federation. Address: 121359, Moscow, 15 Marshala Timoshenko St.
Galina A. Komleva, therapist at Central Clinical Hospital with Polyclinic of the Administration of the President of the Russian Federation. Address: 121359, Moscow, 15 Marshala Timoshenko Str.
E-mail: k-g-a-l@yandex.ru
Irina N. Pikunova, therapist at Central Clinical Hospital with Polyclinic of the Administration of the President of the Russian Federation. Address: 121359, Moscow, 15 Marshala Timoshenko St.
Anna I. Peredelkina, cardiologist at Central Clinical Hospital with Polyclinic of the Administration of the President of the Russian Federation. Address: 121359, Moscow, 15 Marshala Timoshenko St.
E-mail: anik_lederep@bk.ru


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