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      The Heart in Wegener’s Granulomatosis


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          Wegener’s granulomatosis (WG) is a necrotizing vasculitis that mainly affects the respiratory tract and kidneys. Of note, involvement of the heart is being increasingly recognized in these patients. Cardiac manifestations can arise from the coronary arteries, pericardium, myocardium, endocardium, valves, conduction system and great vessels, but in most cases cardiac involvement is clinically silent. Consequently, a regular cardiovascular evaluation, including echocardiography, should be performed in every patient with WG, while patients with WG flare should be closely monitored for cardiac complications even in the absence of specific symptoms.

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          Most cited references 11

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          Cardiac complications of Wegener granulomatosis: a case report of complete heart block and review of the literature.

          Wegener granulomatosis is a necrotizing vasculitis whose target organs are classically the upper and lower respiratory tracts and the kidneys. There has been other end-organ involvement documentation, emphasizing the disseminated nature of this disease, but the literature concerning cardiac involvement is limited. The few case reports and general reviews show that the two most common histologic cardiac manifestations are pericarditis and coronary arteritis, each occurring in 50% of the reported cases. The most frequent clinical manifestation is cardiac arrhythmias that are manifested as supraventricular tachyarrhythmias. We report an unusual cardiac manifestation, a case of complete heart block, occurring during the active stage of Wegener granulomatosis. The problem this case presented and the management are reported. The literature dealing with the cardiac involvement in Wegener granulomatosis is reviewed, and the specific histopathologic findings and the pathophysiologic mechanisms of this involvement are discussed.
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            Cardiac Wegener's granulomatosis masquerading as left atrial myxoma.

            A 56-year-old woman was referred with mitral regurgitation, left ventricular dysfunction, and a sessile mass on the anterior leaflet of her mitral valve. The initial impression from echocardiography was that she had a left atrial myxoma. At operation, we found an intense inflammatory process diagnosed as Wegener's granulomatosis. It also involved the aortic valve and contiguous myocardium.
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              Cardiac involvement in patients with Wegener's granulomatosis


                Author and article information

                S. Karger AG
                April 2004
                28 April 2004
                : 102
                : 1
                : 7-10
                aDepartment of Cardiology, ‘G. Hatzikosta’ General Hospital of Ioannina, Ioannina, bDepartment of Medicine, Psychiatric Hospital of Attica, Athens, Greece
                76995 Cardiology 2004;102:7–10
                © 2004 S. Karger AG, Basel

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                Tables: 1, References: 50, Pages: 4


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