A cohort study reveals myocarditis to be a rare and life-threatening presentation of large vessel vasculitis

Seminars in Arthritis and Rheumatism
Katie BechmanJustin C Mason

Abstract

The predominant forms of adult large vessel vasculitis (LVV) are giant cell arteritis (GCA) and Takayasu arteritis (TA). Cardiac involvement in LVV is a cause of morbidity and mortality, particularly in TA. Cardiac failure is most commonly secondary to uncontrolled arterial hypertension or myocardial ischaemia. Pulmonary hypertension and aortic valve incompetence following ascending aortic dilatation represent other serious cardiovascular complications. However, cardiac failure as a consequence of myocarditis is rarely reported, principally in single case reports or in autopsy studies. The Imperial College LVV database was, retrospectively, reviewed to identify patients with cardiac involvement at presentation. Patients with evidence for myocarditis were identified. The cardiac presentation, imaging studies and subsequent medical and surgical management were reviewed in detail. The cohort included 139 patients with TA and 24 with GCA. Sixteen presented with cardiac failure without a history of ischaemic coronary heart disease, 14 (10%) with TA and 2 (8.3%) with GCA. Cardiovascular disease identified at presentation included aortic regurgitation (n = 11), myocarditis (n = 4) and hypertensive cardiomyopathy secondary to renal art...Continue Reading

Citations

Apr 21, 2018·Expert Review of Clinical Immunology·Michael SchirmerCarlo Salvarani
Aug 29, 2020·Current Rheumatology Reports·Luis H Silveira
Apr 11, 2018·Rheumatology·Enrico Tombetti, Justin C Mason
Aug 20, 2020·Current Heart Failure Reports·George Markousis-MavrogenisSophie I Mavrogeni
Oct 16, 2020·The International Journal of Cardiovascular Imaging·Alessandro GiolloJacqueline Andrews
Oct 1, 2019·La Presse médicale·Laurent Sailler, Kim Paricaud
Jun 1, 2021·Frontiers in Cardiovascular Medicine·Yaxin ZhouZhenbiao Wu
Jun 18, 2021·Rheumatology·Andrew PorterJustin C Mason
Jul 3, 2021·European Journal of Internal Medicine·Alessandro TomelleriLorenzo Dagna
Dec 15, 2021·Modern Rheumatology Case Reports·Keita KanamoriShuichi Ito

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