Objective: to evaluate cardiovascular characteristics of patients with hemorrhagic fever with renal syndrome (HFRS). Patients and methods. We performed clinical, instrumental, and laboratory examination of 220 patients with HFRS of various severity and 30 healthy controls. Results. Hypotension and bradycardia were the most common hemodynamic changes observed in the initial and oligouric periods respectively. Significant ECG changes in patients with HFRS include sinus bradycardia, atrioventricular block, acute right heart strain (primarily the right atrium), changes in the terminal part of the ventricular complex (associated with electrolyte disorders in the majority of patients), and, sometimes, myocarditis. Increased serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with HFRS directly correlate with creatinine levels and inversely correlated with blood pressure (р < 0.05). Conclusion. We recommend measuring troponin I levels in patients with ECG changes in order to assess the type of myocardial damage. Increased NT-proBNP levels in HFRS patients presumably indicate the negative effect of this propeptide on hemodynamics in the acute period of the disease. © 2018, Dynasty Publishing House. All rights reserved.