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Cardiovascular Complications from Tuberculosis
Germantė Mikalajūnaitė1, Egidija Rinkūnienė1,2,3, Alma Čypienė1,2,3
1Institute of Clinical Medicine, Clinic of Cardiac and Vascular Diseases, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania.
Abstract:
Tuberculosis (TB) is a contagious disease caused by Mycobacterium tuberculosis (M. tuberculosis) and is transmitted through airborne particles. Although TB usually damages the lungs, this disease can also cause complications in various organs, including the cardiovascular system. Indeed, pericarditis represents the most frequently reported cardiac manifestation of TB, and may present alongside fever, dyspnea, cough, or increased central venous pressure, hepatomegaly, and peripheral edema. Tuberculous-related pericarditis treatment is challenging due to the poor penetration of anti-tuberculous drugs into the pericardium. Myocarditis is another form of cardiac manifestation and is often associated with arrhythmias. Tuberculous aortitis typically causes dilatation leading to pseudoaneurysm formation and is usually asymptomatic; however, this manifestation can result in sepsis, aortic rupture, or even death, although rarely. Cardiac tuberculomas may present with general symptoms and can impair heart function by obstructing the outflow tracts, leading to ventricular dysfunction. Additionally, the primary treatment of TB carries cardiotoxicity risks, such as various arrhythmias. Moreover, TB significantly increases the risk of cardiovascular conditions, including myocardial infarction and coronary artery obstruction. Therefore, early recognition and a multidisciplinary approach are crucial to prevent severe outcomes such as sudden cardiac death, sepsis, or aortic rupture. Thus, this review highlights the spectrum of TB-related cardiac complications and underscores the importance of greater awareness and timely multidisciplinary care.
Insights
Tuberculosis (TB) can affect the heart, causing complications like pericarditis and myocarditis. Early diagnosis and multidisciplinary care are vital to prevent severe cardiovascular outcomes from TB infection.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Tuberculosis (TB), caused by Mycobacterium tuberculosis, primarily affects the lungs but can manifest in the cardiovascular system.
- Cardiac complications of TB include pericarditis, myocarditis, aortitis, and cardiac tuberculomas, posing significant clinical challenges.
- TB treatment itself can carry cardiotoxicity risks, and TB infection increases the likelihood of cardiovascular events.
Purpose of the Study:
- To review the spectrum of cardiac complications associated with Tuberculosis.
- To emphasize the challenges in diagnosing and treating TB-related cardiac conditions.
- To highlight the importance of early recognition and multidisciplinary management for TB cardiac manifestations.
Main Methods:
- This review synthesizes current literature on cardiovascular manifestations of Tuberculosis.
- It examines clinical presentations, diagnostic challenges, and treatment strategies for TB-related heart disease.
- The review focuses on pericarditis, myocarditis, aortitis, and cardiac tuberculomas.
Main Results:
- Tuberculous pericarditis is the most common cardiac manifestation, often difficult to treat due to poor drug penetration.
- Tuberculous aortitis can lead to aortic dilatation, pseudoaneurysm, and rupture, while cardiac tuberculomas may obstruct heart function.
- TB infection is linked to increased risks of myocardial infarction and coronary artery obstruction, alongside treatment-induced cardiotoxicity.
Conclusions:
- Cardiovascular complications of TB are diverse and can lead to severe outcomes, including sudden cardiac death, sepsis, and aortic rupture.
- Timely diagnosis and a multidisciplinary approach involving cardiologists and infectious disease specialists are crucial.
- Increased awareness and prompt management are essential to mitigate the impact of TB on cardiovascular health.
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