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Entzündliche Herzerkrankungen bei primär extrakardialen Erkrankungen

Inflammatory cardiac diseases by primary extracardial diseases

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Zusammenfassung

Allgemeininternistische Erkrankungen aus der Gastroenterologie, Rheumatologie und Infektiologie können als immunologische Systemerkrankungen neben dem Darm, dem Bewegungsapparat und dem Immunsystem auch das Herz in Mitleidenschaft ziehen. Am Herzen können dabei sämtliche Strukturen und Funktionen betroffen sein, vornehmlich aber Perikard und Myokard. Die Perikarditis bei Lupus erythematodes bzw. chronisch entzündlicher Darmerkrankung, die Myokarditis bei HIV-Infektion bzw. Lyme-Erkrankung sind Beispiele kardialer Beteiligungen allgemeininternistischer Systemerkrankungen. Die pathogenetischen Ursachen sind vielfältig von direkter zytotoxischer Wirkung bei HIV- und Borrelia-burgdorferi-Infektion, von induzierter Vaskulitis bis hin zur Aktivierung von lokalen Gerinnungsfaktoren bei Lupus erythematodes und chronisch entzündlicher Darmerkrankung. Aufgrund der zunehmend besseren Behandlungsmöglichkeiten allgemeininternistischer Erkrankungen und den daraus resultierenden Langzeitverläufen werden krankheitsbedingte und therapiebedingte kardiovaskuläre Sekundärkomplikationen wie die Perikarditis und Myokarditis zunehmend klinische Bedeutung gewinnen.

Abstract

As systemic immunological disorders, internal diseases in gastroenterology, rheumatology and infectiology can, in addition to the bowels, potentially involve the musculo-skeletal system, the immunological system and heart structures. All structures and functions of the heart can be affected. Pericarditis in lupus erythematosus and chronic inflammatory bowel disease, myocarditis in HIV infection and lyme disease are examples of cardiac manifestations of internal diseases. The pathogenetic causes can be manifold, such as direct cytotoxic effects in HIV or Borrelia burgdorferi infections, induced vasculitis and local activation of coagulation factors as in lupus erythematosus or chronic inflammatory bowel disease. Improved treatment options have led to more long-lasting courses of internal diseases, such as in infectious diseases, lupus erythematosus and chronic inflammatory bowel disease, thus cardiovascular complications such as pericarditis and myocarditis gain increasing importance as a consequence of chronic disease and therapy-related damage.

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  1. Klinik für Kardiologie, Pneumologie und Angiologie, Heinrich-Heine Universität, Moorenstraße 5, 40225, Düsseldorf, Deutschland

    M. Brehm, P. Rellecke & B.E. Strauer

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  1. M. Brehm
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  2. P. Rellecke
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  3. B.E. Strauer
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Correspondence to M. Brehm.

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Brehm, M., Rellecke, P. & Strauer, B. Entzündliche Herzerkrankungen bei primär extrakardialen Erkrankungen. Internist 49, 27–33 (2008). https://doi.org/10.1007/s00108-007-1949-z

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