Cardiovascular system damage in the late-onset Pompe disease

I. Leontieva, Yu. S. Isaeva, I. Miklashevich, S. A. Thermosesov
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Abstract

The article presents a clinical case of metabolic hypertrophic cardiomyopathy against the background of a late-onset form of Pompe disease, illustrating the difficulties of differential diagnostic search for the cause of the disease. The clinical, laboratory and genetic aspects of the diagnosis of Pompe disease are highlighted. The features of laboratory diagnostics, the difficult path to the correct diagnosis and the appointment of enzyme replacement therapy are discussed. Much attention is paid to the clinical symptoms of the disease — the most significant damage to the cardiovascular system, there is no damage to the musculoskeletal sphere. Clinical picture of late Pompe disease is presented: cardiac rhythm and conduction disorders (ventricular preexcitation syndrome — multiple additional atrioventricular fenestrations), unstable ventricular tachycardia, supraventricular tachycardia, sinus node weakness syndrome. Considered approaches to the prevention of sudden cardiac death the patient underwent surgical treatment: radiofrequency ablation, endocardial implantation of a cardioverter defibrillator. Pathogenetic therapy for Pompe disease has been started.
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迟发性庞贝病的心血管系统损害
本文介绍了一个代谢性肥厚性心肌病的临床病例,背景是迟发性庞贝病,说明了鉴别诊断寻找疾病原因的困难。临床,实验室和遗传学方面的诊断庞贝病是突出。讨论了实验室诊断的特点、正确诊断的困难路径和酶替代治疗的确定。人们非常关注该病的临床症状——对心血管系统的损害最显著,对肌肉骨骼球体没有损害。晚期Pompe病的临床表现:心律和传导障碍(心室预兴奋综合征-多个额外的房室开窗),不稳定的室性心动过速,室上心动过速,窦房结无力综合征。考虑到预防心源性猝死的方法,患者接受了手术治疗:射频消融,心内膜植入心律转复除颤器。庞贝病的病原学治疗已经开始。
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