Cardiac involvement in systemic diseases

Cardiovascular features in systemic diseases are common. Transthoracic echocardiography represents a first-line diagnostic tool among these patients. Pericarditis is the most frequent cardiac complication of rheumatoid arthritis. In systemic lupus erythematosus, echocardiography shows usually small or moderate pericardial effusion in up to 55% of patients. In this group, Libman-Sacks vegetations develop mainly on the mitral valve but also can be seen on other valves. Pulmonary hypertension is one of the most important complications adversely influencing survival of systemic sclerosis patients. In antiphospholipid syndrome, the most common echocardiographic abnormality is diffuse or focal leaflet thickening, seen in 40-60% of subjects. Among Marfan syndrome patients, aortic root aneurysm is the most dangerous complication. In this chapter the authors also report the echocardiographic abnormalities occurring in rare systemic diseases including carcinoid, haemochromatosis, sarcoidosis, and amyloidosis. Moreover, echocardiographic changes in neoplastic disease and in patients undergoing chemotherapy and/or radiotherapy are also described.