[The heart in rheumatic diseases]

As systemic immunological disorders inflammatory rheumatic diseases potentially involve organs and structures beyond the musculo-skeletal system including skin and blood vessels. Various neurological, renal, pulmonary, hematological and cardiac manifestations contribute to the broad clinical picture of connective tissue diseases and vasculitides. Regarding cardiac disease all structures of the heart may be affected. Pericarditis in lupus, mitral valve changes in the antiphospholipid syndrome, myocarditis and coronary artery stenosis in the systemic vasculitides are typical examples in systemic rheumatic diseases. Beyond this, pulmonary hypertension in systemic sclerosis or congenital heart block in newborns of lupus patients are further cardiac issues. Since better treatment options led to more long-lasting courses in connective tissue diseases, cardiovascular complications as a consequence of chronic disease- and therapy-related damage gain increasing attention.