Myocarditis: A Rheumatologic Perspective
Keywords:Myocarditis, inflammation, microngiopathy, vasculitis, autoimmune rheumatic diseases
Myocarditis is an uncommon complication in patients with autoimmune rheumatic diseases. The majority of cases refer to postmortem findings. The mechanism of myocardial damage in Connective Tissue Diseases (CTDs) depends on the pathophysiology of underlying disease. Systemic inflammation, impaired microvascular circulation and vasculitis affect myocardial remodeling process, cause repeated focal ischemia resulting in hypertrophy, fibrosis of myocardium, conductive system and thus reduced contractility. Additionally, immunological abnormalities, coexisting myositis and the degree of disease activity are predictors of myocarditis progression. Clinical manifestations range from subclinical to severe forms. Early recognition is important for institution of appropriate immunomodulatory therapy.
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