Cardiac Involvement by Systemic Diseases

Abstract

In systemic diseases, such as connective tissue diseases and metabolic syndromes, involvement of multiple organs is the general rule. Yet cardiac involvement in many systemic diseases is not well recognized, as the dominant manifestations frequently reside in other organ systems. Cardiac involvement is very common with many systemic diseases and may account for serious morbidity or mortality. The early recognition of cardiac involvement may impact upon patient management and prognosis. For instance, in a patient with thalassemia requiring frequent blood transfusions, the detection of myocardial dysfunction due to myocardial iron deposition will lead to intensification of chelation therapy. The major categories of systemic diseases with cardiac involvement are listed in Table 17.1. Instead of providing an encyclopedic description of cardiac manifestations in a wide range of systemic diseases, the approach taken in this chapter is to outline important principles that should be considered in dealing with patients with any systemic disease. The intention is that a good understanding of the unifying principles is likely to be more inclusive of the variable and ever expanding range of cardiac manifestations than any comprehensive listing, and thus more useful to the echocardiographers who evaluate these patients. We do not provide in-depth review of many of the diseases that are mentioned, but instead discuss specific diseases in detail to illustrate the underlying principles.