Cardiac involvement in patients with Wegener's granulomatosis

Abstract

Wegener's granulomatosis (WG) is a systemic necrotizing vasculitis, which could potentially affect any organ system. However, there have only been a few reports on cardiac involvement. We described the echocardiographic findings in nine patients affected by WG. A complete M-mode, two-dimensional, Doppler and color-Doppler transthoracic echocardiogram was performed in nine patients (seven females and two males) affected by WG. In each patient, cardiac abnormality, for example, valvular damage, left ventricular global systolic dysfunction, or pericardial effusion, was detected. In particular, heart valve disease was found in eight patients, and in three cases, aortic valve insufficiency, which was severe enough to require surgical valve replacement, was observed. Cardiac involvement in patients with WG is common. In particular, there is a high frequency of aortic valve abnormalities. Thus, an echocardiographic study should be routinely performed.

Granulomatosis with polyangiitis (Wegener’s) presenting as the right ventricular masses: A case report and review of the literature.

“…Other findings included valvulitis, left ventricular aneurysm and a large intracardiac mass (34,35). In another study conducted by Morelli et al, of nine GPA patients with echocardiography, aortic valve thickening in eight patients was detected (14). Likewise, Kosovsky et al, reported a 16-year-old boy who was diagnosed as GPA after a cardiac mass had been detected and the pathological examination had revealed granulomatous vasculitis (13).…”

“…Lungs in 72%, kidneys in 36% and eyes in 24%, while heart involvement was found in only 8% of cases (13). Cardiac involvement may be subclinical or the principal source of symptoms (14,15). It usually occurs late in the course of the disease but it may also be the first manifestation (15)(16)(17)(18)(19)(20).…”

Cardiac manifestations in antineutrophil cytoplasmic autoantibody (ANCA) — associated vasculitides

“…The few case reports and general reviews show that the two most common cardiac manifestations are pericarditis and coronary arteritis (50% of cases), but myocarditis, endocarditis, and conduction system disturbances are also described [10][11][12][13].…”

Concomitant presentation of myocarditis and non-bacterial thrombotic endocarditis in a patient with granulomatosis with polyangiitis

“…1 According to different studies, echocardiographic abnormalities due to cardiac involvement in GPA is relatively common, including systolic dysfunction, pericardial effusion, valvular involvement and so far. 7,8 Nonbacterial thrombotic endocarditis (NBTE) is a rare manifestation of GPA and to our knowledge its concomitant presentation with myocarditis is not reported to date. Herein, we report a case of GPA, who diagnosed with both myocarditis and NBTE.…”