Chronic Dermatomyositis with Intermittent Trifascicular Block

Lightfoot, Paul R.; Bharati, Saroja; Lev, Maurice

doi:10.1378/chest.71.3.413

Cited by 36 publications

(9 citation statements)

References 11 publications

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“…Twelve of these were case reports contributing 14 patients [12][13][14][15][16][17][18][19][20][21][22][23]. The other 21 articles were either cohort studies or case series.…”

Section: Article and Patient Characteristicsmentioning

confidence: 99%

“…Total cardiac deaths reported in IIM patients were 51 (including 6 deaths in case reports [12][13][14]16,18,20]). In 11 patients, the cause of death was reported to be CHF (21%), 9 patients died of MI (18%), 5 each (10%) had complete heart block and unspecified arrhythmia and 2 had sudden cardiac death (Fig.…”

Section: Cardiac Mortalitymentioning

confidence: 99%

“…EPS has been reported in seven patients from four articles [14,17,22,40]. Patients presented with symptoms of lightheadedness and dyspnea with or without palpitations.…”

Section: Electrophysiologic Study (Eps)mentioning

confidence: 99%

See 2 more Smart Citations

Clinical cardiac involvement in idiopathic inflammatory myopathies: A systematic review

Gupta

Wayangankar

Targoff

et al. 2011

International Journal of Cardiology

109

105

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“…Twelve of these were case reports contributing 14 patients [12][13][14][15][16][17][18][19][20][21][22][23]. The other 21 articles were either cohort studies or case series.…”

Section: Article and Patient Characteristicsmentioning

confidence: 99%

Section: Cardiac Mortalitymentioning

confidence: 99%

See 1 more Smart Citation

Clinical cardiac involvement in idiopathic inflammatory myopathies: A systematic review

Gupta

Wayangankar

Targoff

et al. 2011

International Journal of Cardiology

109

105

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“…A fatal evolution in relation to myocarditis and ventricular dysfunction or high-degree atrioventricular block has also been reported (4). Of note, epicardial arteries are rarely stenotic despite ischemic ECG changes (5,6). However, intramyocardial occlusive small-vessel disease may be present in 20% of patients at autopsy (7).…”

Section: Discussionmentioning

confidence: 99%

Myocardial dysfunction in polymyositis

Sénéchal¹,

Crête

Couture

et al. 2006

Canadian Journal of Cardiology

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Myocardial involvement in polymyositis is occasionally suspected, but symptomatic cardiac dysfunction is rarely reported. Described in the present report is a 48-year-old woman with a two-year history of polymyositis who suddenly developed near fatal ventricular arrhythmia, and a 56-year-old man with a relapsing polymyositis who developed severe systolic dysfunction. These two cases emphasize the importance of systematic cardiac evaluation when the diagnosis of polymyositis is initially made and the necessity of re-evaluating cardiac function, even in the presence of clinical remission and normalization of creatine phosphokinase with treatment.

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“…In current clinical practice, a vast majority of pointof-care, sensitive, high-sensitivity cTnI and cTnT assays run on automated platforms, and the guidelines recommended the high-sensitivity ones for management of ACS but did not recommend routine assays for nonischemic conditions unless for special objectives. 25,35) For cardiac involvement in IIMs, unlike myocardial infarction in which necrosis or injury of cardiomyocytes occur quickly after ischemia attack and the rapidly elevated cardiac troponins disappear after several days, the histopathological changes of the heart tend to be slow and diffused according to previous studies, 8,20,36) and the elevation of cardiac troponins may persist due to continuous damage induced by inflammatory activity. Theoretically, it is reasonable that the routine use of cTnI assay for early detection of heart involvement, preferable to high-sensitivity ones allowing for detection of minor myocardium damage, especially in the early stage when ECG and cardiac imaging prefer to be negative and patients are more likely to be asymptomatic, and normal levels of cTnI make the diagnosis unlikely.…”

Section: Cardiac Troponin In Patients With Iimsmentioning

confidence: 94%

Diagnostic Approach to Cardiac Involvement in Idiopathic Inflammatory Myopathies

2018

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Cardiac involvement in idiopathic inflammatory myopathies (IIMs) attracts more attention than it ever did because of its morbidity and impact on worse prognosis, although the accurate information needs further epidemiological studies. Early identification and intervention for the diseased heart may help improve the clinical outcomes of IIMs with cardiac involvement. Cardiac troponin assays, allowing for sensitive detection of minor myocardium injury, may provide a new way for early detection for heart involvement in IIMs. While elevated cardiac troponin I (cTnI) specifically indicates cardiomyocyte injury, the elevation of cardiac troponin T (cTnT) levels may not only derive from damaged heart but also diseased adult skeletal muscles in which cTnT could re-express in patients with IIMs. cTnI is the biomarker of choice for diagnosis of cardiac involvement and may also be a prognostic factor in IIMs. Meanwhile, electrocardiography (ECG), cardiac imaging (e.g., echocardiography, cardiac magnetic resonance) and histopathological techniques (e.g., endomyocardial biopsy) take on different degrees of importance for the diagnosis of cardiac involvement. We propose a diagnostic strategy combining the routine use of cTnI assay with other techniques (routine ECG and echocardiography, cardiac magnetic resonance, and or endomyocardial biopsy in necessity) and clinical investigation for early detection of heart involvement in IIMs. Future researches are required to validate the algorithm for performance.

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Chronic Dermatomyositis with Intermittent Trifascicular Block

Cited by 36 publications

References 11 publications

Clinical cardiac involvement in idiopathic inflammatory myopathies: A systematic review

Clinical cardiac involvement in idiopathic inflammatory myopathies: A systematic review

Myocardial dysfunction in polymyositis

Diagnostic Approach to Cardiac Involvement in Idiopathic Inflammatory Myopathies

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