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[Cardiac manifestations of connective tissue diseases]
Insights
Cardiac manifestations are common in connective tissue diseases, particularly Systemic Lupus Erythematosus (SLE) and Rheumatoid Arthritis (RA). Early detection using electrocardiography (ECG) and echocardiography (ECO) is recommended, even without overt clinical symptoms.
Area of Science:
- Cardiology
- Rheumatology
- Internal Medicine
Context:
- Connective tissue diseases (CTDs) encompass a group of autoimmune disorders affecting connective tissues.
- Cardiac involvement is a significant but often underdiagnosed complication of CTDs.
- Understanding the spectrum of cardiac manifestations is crucial for comprehensive patient management.
Purpose:
- To investigate the prevalence and types of cardiac manifestations in patients with various connective tissue diseases.
- To evaluate the utility of diagnostic tools like ECG and echocardiography (ECO) in detecting subclinical cardiac involvement.
- To establish the frequency of cardiac involvement across different CTDs.
Summary:
- A retrospective study analyzed 213 patient files over 21 years, identifying cardiac manifestations in 90% of Systemic Lupus Erythematosus (SLE) cases, with pericarditis being most common.
- Rheumatoid Arthritis (RA) showed cardiac involvement in 41% of patients, including pericarditis, valvulopathy, and coronaropathy.
- Other CTDs like Progressive Systemic Sclerosis (PSS) and Polyarteritis Nodosa (PN) exhibited arrhythmias, conduction disturbances, myocardial ischemia, and hypertension, while Ankylosing Spondylitis (AS) showed no cardiac findings.
Impact:
- Cardiac manifestations are frequent in CTDs, often presenting with abnormal findings on ECG, ECO, and pathology.
- The study highlights the importance of routine cardiac screening using ECG, ECO, Holter monitoring, and myocardial perfusion scans.
- Early detection and management of cardiac involvement can improve outcomes for patients with connective tissue diseases.
Abstract:
We have studied the cardiac manifestations of connective tissue diseases. In 213 files of patients with connective tissue disease of the Department of Medicina I, Hospital Santa Maria, during 21 years. Cardiac manifestations were observed in 63 (90%) SLE. Pericarditis was the most frequent manifestation and occurred in 33 patients (43%). The cardiac manifestations were observed in 40 (41%) RA. Pericarditis appeared in 11 patients, valvulopathy in 12 patients and coronaropathy in 11 patients. In 10 of PD diagnosed patients, ECG abnormalities were the only findings. Arrhythmias, conduction disturbances, cardiac failure and coronaropathy were the cardiac manifestations of PSS in 11 patients. Polyarteritis Nodosa patients had myocardial ischemia and another had a malignant hypertension diagnosis. We found pericardial effusion in one patient and angina in another one with MCTD diagnosis. We did'nt find any cardiac manifestation in AS. Cardiac manifestations are frequent in connective tissue diseases. The ECG, ECO and pathology show abnormal findings. Although there is not clinical cardiological expression of the disease we suggest the use of ECG. ECO Holter electrocardiography and isotopic myocardial perfusion scan technics in the clinical evaluation of such patients.