Cardiac manifestations of rheumatological conditions: a narrative review

Area of Science:

• Rheumatology
• Cardiology
• Internal Medicine

Background:

• Cardiovascular diseases (CVDs) are prevalent in systemic rheumatologic diseases.
• Cardiac involvement can be the initial presentation, leading patients to cardiologists first.
• These manifestations range from subclinical to severe, affecting heart structures and increasing mortality/morbidity.

Purpose of the Study:

• To highlight the significance of cardiac involvements in systemic rheumatologic diseases.
• To emphasize the importance of timely diagnosis for effective treatment selection.
• To discuss the link between systemic inflammation and cardiovascular risk.

Main Methods:

• Review of clinical presentations and outcomes in patients with rheumatologic diseases and cardiac involvement.
• Analysis of the impact of systemic inflammation on cardiovascular health.
• Examination of current treatment strategies and guideline gaps.

Main Results:

• Premature atherosclerosis and ischemic heart disease are elevated in rheumatoid arthritis and systemic lupus erythematosus.
• Aggressive control of systemic inflammation shows potential in reducing cardiovascular disease risk, particularly ischemic heart disease.
• Despite improved outcomes with primary disease treatment, specific guidelines for integrated cardiovascular risk management are absent.

Conclusions:

• Cardiac manifestations are a critical and often early feature of systemic rheumatologic diseases.
• Managing systemic inflammation is key to reducing cardiovascular complications.
• There is an unmet need for specific guidelines addressing the aggressive control and prevention of traditional cardiovascular risk factors in these patients.