Related Experiment Video
Updated: Aug 15, 2026
Noninvasive Assessment of Cardiac Abnormalities in Experimental Autoimmune Myocarditis by Magnetic Resonance Microscopy Imaging in the Mouse
Published on: June 20, 2014
Cardiac involvement in autoimmune myositis and mixed connective tissue disease
1Rheumatology Unit, Department of Medicine, Karolinska University Hospital, Solna Karolinska Institutet, Stockholm, Sweden. ingrid.lundberg@medks.ki.se
Insights
Cardiac involvement in inflammatory myopathies, like myositis, often presents as subclinical conduction abnormalities and arrhythmias. Cardiovascular issues are a major cause of death, highlighting the need to recognize these often-overlooked cardiac manifestations.
Area of Science:
- Rheumatology
- Cardiology
- Internal Medicine
Background:
- Idiopathic inflammatory myopathies (myositis) can present with cardiac manifestations.
- While overt cardiac involvement is rare, subclinical findings like conduction abnormalities are frequent.
- Cardiovascular disease is a significant cause of mortality in myositis patients.
Purpose of the Study:
- To review the spectrum of cardiac involvement in idiopathic inflammatory myopathies.
- To highlight the prevalence and significance of subclinical cardiac manifestations.
- To discuss potential pathophysiologic mechanisms and implications for patient outcomes.
Main Methods:
- Literature review of clinical cardiac manifestations in myositis.
- Analysis of reported subclinical findings, including ECG-detected abnormalities.
- Examination of cardiovascular mortality data in myositis cohorts.
Main Results:
- Congestive heart failure, conduction abnormalities (including heart block), and coronary artery disease are common.
- Subclinical conduction abnormalities and arrhythmias are frequently detected by ECG.
- Cardiac involvement can occur in juvenile dermatomyositis, though less frequently.
- Myocarditis, coronary artery disease, and small vessel myocardial disease are potential mechanisms.
- In mixed connective tissue disease (MCTD), pericarditis and pulmonary hypertension are more common.
Conclusions:
- Cardiac involvement in myositis, though often subclinical, is a critical factor in patient morbidity and mortality.
- Early detection and management of cardiac manifestations are essential.
- Small vessel disease plays a role in cardiovascular complications in both myositis and MCTD.
Abstract:
The clinical cardiac manifestations most frequently reported in idiopathic inflammatory myopathies, myositis, are congestive heart failure, conduction abnormalities, that may lead to complete heart block and coronary artery disease. Although clinically overt cardiac involvement is rarely reported in myositis patients, subclinical manifestations are frequently observed and are predominated by conduction abnormalities and arrhythmias detected by ECG. Furthermore, cardiovascular manifestations constitute a major cause of death in myositis, thus cardiac involvement maybe overlooked in these patients. Also children with juvenile dermatomyositis may develop cardiac involvement although the frequency seems to be low. The underlying pathophysiologic mechanisms that may cause cardiac manifestations could involve myocarditis and coronary artery disease as well as involvement of the small vessels of the myocardium. In patients with mixed connective tissue disease (MCTD) clinically significant cardiac involvement is also rare, the most frequently reported manifestations being pericarditis and pulmonary hypertension, the latter often attributable to small vessel disease, and often a prognostic unfavourable manifestation.
Related Concept Videos
01:27Myocarditis II: Clinical Features and Diagnostic Tests
01:21Myocarditis I: Introduction
01:14Myocarditis III: Medical Management
01:22Myocarditis IV: Nursing Management
01:23Rheumatic Heart Disease I: Introduction
01:25Cardiomyopathy I: Introduction and Classification