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Clinical Features of Myositis: Cardiac Manifestations

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Managing Myositis

Abstract

The reported incidence of cardiac involvement in patients with idiopathic inflammatory myopathies (IIM) is increasing, and cardiovascular events are recognized as one of the major causes of morbidity and mortality. Histopathologic analyses suggest that immune-mediated inflammation is the major cause of damage in the heart muscle as well as the cardiac conduction system, which may lead to congestive heart failure and arrhythmias. Subclinical cardiac involvement is reported much more commonly than clinically evident cardiac manifestations, and the incidence varies between 13% and 72% of IIM patients dependent on the diagnostic modalities. A threefold to fivefold increased risk of myocardial infarction (MI) has been reported in patients with polymyositis and dermatomyositis compared to nonmyositis controls. All patients with a diagnosis of IIM should undergo a detailed cardiac history at initial evaluation and, if required, a screening EKG and echocardiogram. Tailored cardiac therapy should be used in conjunction with immunosuppression as indicated. IIM patients require continued cardiac “vigilance” even when the skeletal muscle disease is in remission.

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Notes

  1. 1.

    Angiotensin-converting enzyme (ACE), angiotensin-II receptor blockers [74

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  1. University of California, Los Angeles, CA, USA

    Sangmee Bae & Christina Charles-Schoeman

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  1. Division of Rheumatology and Clinical Immunology, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA

    Rohit Aggarwal

  2. Division of Rheumatology and Clinical Immunology, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA

    Chester V. Oddis

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Bae, S., Charles-Schoeman, C. (2020). Clinical Features of Myositis: Cardiac Manifestations. In: Aggarwal, R., Oddis, C. (eds) Managing Myositis. Springer, Cham. https://doi.org/10.1007/978-3-030-15820-0_8

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