The aim is to compare the changes in the structural and functional state of the left ventricular myocardium in patients after COVID-19 and to determine the antianginal and antiischemic activity of molsidomine (Sidnopharm) in this category of patients. Object and methods of research. We examined 120 persons aged 58±8.23 years (48.4% of women and 51.6% of men), 60 of whom relapsed to COVID-19 and had complaints from the cardiovascular system, including cardialgia. All patients in the complex treatment of major diseases received statins, renin-angiotensin-aldosterone system blockers, antiplatelet agents and other prescribed therapy. Patients with COVID-19 were divided into two groups (30 individuals). Sidnopharm at a dose of 2 mg 2 times a day for 1 month was added in the treatment program of the 1st (main) group, the 2nd (comparison group) received any antianginal drugs, except for nitrates of prolonged action. Results. Patients who underwent COVID-19 in the past 6 months were found to have relatively larger left heart volumes and left ventricular myocardial mass compared to those who did not become ill. They have relative hypersympathicotonia with a predominance of daytime arrhythmic activity. According to speckle-tracking echocardiography, patients with COVID-19 and long-term cardialgia have a decrease in local contractility of predominantly basal segments of the left ventricular wall due to subendocardial microvascular ischemia. Patients with post-COVID-19 cardialgia showed a significant reduction in both the severity of complaints and instrumental data of ischemia: the number of episodes of depression of the ST segment (according to Holter monitoring) and improved contractility of mainly basal and middle sections of the walls of the left ventricle (according to speckle-tracking echocardiography) due to the improvement of their blood supply on the background of treatment with Sidnopharm at a dose of 2 mg 2 times a day for 30 days. Conclusion. Sidnopharm — coronary dilator, nitric oxide donor, endothelial protector, antianginal and anti-ischemic drug, which is used mainly in the treatment of coronary heart disease — can also be recommended to prescribe in the treatment of patients with post-COVID-19 syndrome.