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Intracardiac thrombus in Behçet's disease: a systematic review
N Mogulkoc1, M I Burgess, P W Bishop
1Department of Pulmonary Medicine, Ege University, Izmir, Turkey. 100046.1102@compuserve.com
Insights
Intracardiac thrombus, a rare complication of Behçet's disease, often presents in young men from the Mediterranean and Middle East. Consider Behçet's disease in patients with right-sided cardiac masses, even without typical symptoms.
Area of Science:
- Cardiology
- Rheumatology
- Internal Medicine
Background:
- Behçet's disease is a rare systemic vasculitis with a predilection for the Silk Road regions.
- Intracardiac thrombus formation is an uncommon but severe complication of Behçet's disease.
Purpose of the Study:
- To review the clinical and pathological features of intracardiac thrombus in Behçet's disease patients.
- To identify risk factors and diagnostic clues for cardiac thrombus in Behçet's disease.
Main Methods:
- A comprehensive literature search was performed using MEDLINE.
- Analysis of clinical and pathological data from reported cases of intracardiac thrombus in Behçet's disease.
Main Results:
- Most reported cases originated from the Mediterranean basin and the Middle East.
- Young men are the most affected demographic, with the right heart being the most common site.
- Intracardiac thrombus was evident at initial disease presentation in over half of the cases.
Conclusions:
- Behçet's disease should be suspected in patients presenting with right-sided cardiac masses, especially young men from the Mediterranean/Middle East.
- Diagnosis is crucial even in the absence of classic Behçet's disease symptoms.
- Early consideration aids in timely management of this serious complication.
Background:
Intracardiac thrombus formation is a rare but serious complication of Behçet's disease. We aimed to review the clinical and pathologic correlates of cardiac thrombus formation in the context of Behçet's disease.
Methods And Results:
A comprehensive search of the medical literature was conducted using MEDLINE including bibliographies of all selected articles. Although the disease has a unique geographic distribution, being most common in the population of the ancient Silk Route, cases complicated by intracardiac thrombus have mostly originated from the Mediterranean basin and the Middle East. Young men appear to be most at risk, with the right heart the most frequent site of involvement. The first symptoms and signs of the disease frequently precede systemic organ manifestations. In those cases in which intracardiac thrombus occurs, it is apparent in more than half of cases on first recognition of the disease.
Conclusion:
A diagnosis of Behçet's disease should be considered if a patient presents with a mass in the right-sided cardiac chambers, even in the absence of the characteristic clinical features of the condition. This is particularly applicable if the patient is a young man from the Mediterranean basin or the Middle East.