Recurrent ventricular tachycardia in a child with juvenile dermatomyositis – an unusual association

Jindal, Geetanjali; Singh, Surjit; Suri, Deepti; Rawat, Amit; Rohit, Manoj Kumar

doi:10.1111/j.1756-185x.2012.01701.x

Cited by 9 publications

(3 citation statements)

References 4 publications

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“…In several case reports, successful pharmacological treatment of arrhythmia, conduction disorders and heart failure in children and adults with myositis are reported. 11 48 91 However, it is hard to decide the effect of the immunosuppressive treatment alone, since these patients also received antiarrhythmic drugs and heart failure management depending on their symptoms. Three studies including 20–44 patients with adult onset DM/PM show an effect of glucocorticoids plus other immunosuppressive drugs on clinical or subclinical heart involvement in the majority of patients.…”

Section: Prevention Diagnostic Work-up/follow-up and Managementmentioning

confidence: 99%

Cardiac involvement in adult and juvenile idiopathic inflammatory myopathies

et al. 2016

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Idiopathic inflammatory myopathies (IIM) include the main subgroups polymyositis (PM), dermatomyositis (DM), inclusion body myositis (IBM) and juvenile DM (JDM). The mentioned subgroups are characterised by inflammation of skeletal muscles leading to muscle weakness and other organs can also be affected as well. Even though clinically significant heart involvement is uncommon, heart disease is one of the major causes of death in IIM. Recent studies show an increased prevalence of traditional cardiovascular risk factors in JDM and DM/PM, which need attention. The risk of developing atherosclerotic coronary artery disease is increased twofold to fourfold in DM/PM. New and improved diagnostic methods have in recent studies in PM/DM and JDM demonstrated a high prevalence of subclinical cardiac involvement, especially diastolic dysfunction. Interactions between proinflammatory cytokines and traditional risk factors might contribute to the pathogenesis of cardiac dysfunction. Heart involvement could also be related to myocarditis and/or myocardial fibrosis, leading to arrhythmias and congestive heart failure, demonstrated both in adult and juvenile IIM. Also, reduced heart rate variability (a known risk factor for cardiac morbidity and mortality) has been shown in long-standing JDM. Until more information is available, patients with IIM should follow the same recommendations for cardiovascular risk stratification and prevention as for the corresponding general population, but be aware that statins might worsen muscle symptoms mimicking myositis relapse. On the basis of recent studies, we recommend a low threshold for cardiac workup and follow-up in patients with IIM.

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Section: Prevention Diagnostic Work-up/follow-up and Managementmentioning

confidence: 99%

Cardiac involvement in adult and juvenile idiopathic inflammatory myopathies

et al. 2016

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“…In systemic sclerosis (SSc), non-sustained VT was described in 7-13%, while SCD was reported in 5-21% of unselected SSc patients [3]. Recently, SAnCtUS, the only multicenter study evaluating VA in SSc, found that a CMR score combining inflammatory and fibrotic indices can provide information regarding VA prediction in SSc patients [38] VT and SCD can be also assessed during polymyositis (PM) and dermatomyositis (DM), although their incidence has been poorly defined [39][40][41][42].…”

Section: Aic In Ard Patientsmentioning

confidence: 99%

Arrhythmogenic Inflammatory Cardiomyopathy in Autoimmune Rheumatic Diseases: A Challenge for Cardio-Rheumatology

et al. 2019

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Ventricular arrhythmia (VA) in autoimmune rheumatic diseases (ARD) is an expression of autoimmune inflammatory cardiomyopathy (AIC), caused by structural, electrical, or inflammatory heart disease, and has a serious impact on a patient’s outcome. Myocardial scar of ischemic or nonischemic origin through a re-entry mechanism facilitates the development of VA. Additionally, autoimmune myocardial inflammation, either isolated or as a part of the generalized inflammatory process, also facilitates the development of VA through arrhythmogenic autoantibodies and inflammatory channelopathies. The clinical presentation of AIC varies from oligo-asymptomatic presentation to severe VA and sudden cardiac death (SCD). Both positron emission tomography (PET) and cardiovascular magnetic resonance (CMR) can diagnose AIC early and be useful tools for the assessment of therapies during follow-ups. The AIC treatment should be focused on the following: (1) early initiation of cardiac medication, including ACE-inhibitors, b-blockers, and aldosterone antagonists; (2) early initiation of antirheumatic medication, depending on the underlying disease; and (3) potentially implantable cardioverter–defibrillator (ICD) and/or ablation therapy in patients who are at high risk for SCD.

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“…VT and SCD can be also assessed during polymyostis (PM) and dermato-myositis (DM), although their incidence has been poorly defined [9][10][11][12][13]. VT in CTDs can be due to various pathologies including myocardial inflammation, myocardial ischemia due to obstructive disease of epicardial coronary arteries, coronary artery spasm, microvascular disease and myocardial scar, either of ischemic or non-ischemic origin.…”

Section: Introductionmentioning

confidence: 99%