The Spectrum of Myocardial Disease in Idiopathic Inflammatory Myopathies

Idiopathic inflammatory myopathies (IIMs) are a group of autoimmune disorders characterized by chronic muscle inflammation. While historically under-recognized, cardiovascular disease has emerged as a leading cause of mortality in IIM patients, with manifestations including myocarditis, arrhythmias, and atherosclerotic cardiovascular disease. Myocarditis, present in up to 38% of IIM patient's post-mortem, varies from subclinical inflammation to fulminant heart failure. Despite the significant impact of cardiac disease on IIM outcomes, standardized screening and management guidelines remain lacking. Future research should focus on defining cardiovascular involvement, improving risk stratification, and developing targeted therapies to optimize long-term outcomes in this high-risk population.