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Behçet's Disease: an Insight from a Cardiologist's Point of View
Giuseppe Cocco1, Armen Yuri Gasparyan
1Cardiology Office, CH-4310 Rheinfelden, Switzerland.
Insights
Behçet
Area of Science:
- Cardiology and Rheumatology
Background:
- Behçet's disease (BD) is a complex inflammatory disorder.
- Vasculitis, particularly perivasculitis, drives its multisystemic manifestations.
- While venous pathology is recognized, cardiac and arterial complications are increasingly noted.
Purpose of the Study:
- To highlight the spectrum of cardiovascular involvement in Behçet's disease.
- To discuss the common cardiac manifestations and challenges in managing vascular complications.
Main Methods:
- Review of existing literature on cardiovascular manifestations in Behçet's disease.
- Analysis of reported cases and clinical observations regarding cardiac and arterial issues.
Main Results:
- Frequent cardiac manifestations include pericarditis, myocardial dysfunction, valvular and coronary issues, and intracardiac thrombi.
- Arterial complications such as aneurysms and thrombosis are significant concerns.
- Treatment primarily focuses on vasculitis suppression, with arterial complications posing management challenges due to bleeding risks.
Conclusions:
- Cardiovascular involvement is a critical, often under-recognized, aspect of Behçet's disease.
- Cardiologists must be vigilant for both symptomatic and asymptomatic cardiovascular threats in BD patients.
- Further research into optimal treatment strategies for vascular complications is warranted.
Abstract:
Behçet's disease (BD) is an enigmatic inflammatory disorder, with vasculitis (perivasculitis) underlying pathophysiology of its multisystemic affections. Venous pathology and thrombotic complications are hallmarks of BD. However, it has been increasingly recognized that cardiac involvement and arterial complications (aneurysms, pseudoaneurysms, rupture and thrombosis) are important part of the course of BD. Pericarditis, myocardial (diastolic and/or systolic dysfunction), valvular and coronary (thrombosis, aneurysms, rupture) involvement, intracardiac thrombi (predominantly right-sided) are, probably, the most frequent cardiac manifestations. Treatment of cardiovascular involvement in BD is largely empirical and aimed at suppression of vasculitis. The most challenging seems to be the treatment of arterial aneurysms and thromboses due to the associated risk of bleedings. Cardiologists should always bear in mind potential threats of (a)symptomatic cardiovascular involvement in BD.
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