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Cardiovascular Tuberculosis

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Extrapulmonary Tuberculosis

Abstract

Tuberculosis, which is still endemic in some countries, and frequently seen in some patient groups including immunocompromised patients, especially with HIV, is associated with a group of important extrapulmonary involvement. The cardiovascular system is one of the involved sites, and some serious complications such as pericarditis, endocarditis, myocarditis, valvular or coronary involvement, arteritis, and aneurysms may be seen. Besides, it has been concluded in several studies that tuberculosis may have an important role in etiology and pathogenesis of Takayasu arteritis, atherosclerosis, and deep vein thrombosis.

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References

  1. Aggarwal A, Chag M, Sinha N, Naik S. Takayasu’s arteritis: role of Mycobacterium tuberculosis and its 65 kDa heat shock protein. Int J Cardiol. 1996;55:49–55.

    Article  CAS  Google Scholar 

  2. Alkhuja S, Miller A. Tuberculosis and sudden death: a case report and review. Heart Lung J Acute Crit Care. 2001;30:388–91. https://doi.org/10.1067/mhl.2001.118304.

    Article  CAS  Google Scholar 

  3. Allins AD, Wagner WH, Cossman DV, et al. Tuberculous infection of the descending thoracic and abdominal aorta: case report and literature review. Ann Vasc Surg. 1999;13:439–44. https://doi.org/10.1007/s100169900280.

    Article  CAS  PubMed  Google Scholar 

  4. Amonkar G, Rupani A, Shah V, Parmar H. Sudden death in tuberculous myocarditis. Cardiovasc Pathol. 2009;18:247–8. https://doi.org/10.1016/j.carpath.2007.12.016.

    Article  PubMed  Google Scholar 

  5. Biedrzycki OJ, Baithun SI. TB-related sudden death (TBRSD) due to myocarditis complicating miliary TB. Am J Forensic Med Pathol. 2006;27:335–6. https://doi.org/10.1097/01.paf.0000233633.16185.32.

    Article  CAS  PubMed  Google Scholar 

  6. Castillo-Martínez D, Amezcua-Guerra LM. Self-reactivity against stress-induced cell molecules: the missing link between Takayasu’s arteritis and tuberculosis? Med Hypotheses. 2012;78:485–8. https://doi.org/10.1016/j.mehy.2012.01.012.

    Article  CAS  PubMed  Google Scholar 

  7. Cherian G. Diagnosis of tuberculous aetiology in pericardial effusions. Postgrad Med J. 2004;80:262–6.

    Article  CAS  Google Scholar 

  8. Choudhary SK, Bhan A, Talwar S, et al. Tubercular pseudoaneurysms of aorta. Ann Thorac Surg. 2001;72:1239–44.

    Article  CAS  Google Scholar 

  9. Cinar B, Enç Y, Göksel O, et al. Chronic constrictive tuberculous pericarditis: risk factors and outcome of pericardiectomy. Int J Tuberc Lung Dis. 2006;10:701–6.

    CAS  PubMed  Google Scholar 

  10. Clough RE, Topple JA, Zayed HA, et al. Endovascular repair of a tuberculous mycotic thoracic aortic aneurysm with a custom-made device. J Vasc Surg. 2010;51:1272–5. https://doi.org/10.1016/j.jvs.2009.12.047.

    Article  PubMed  Google Scholar 

  11. Dentan C, Epaulard O, Seynaeve D, et al. Active tuberculosis and venous thromboembolism: association according to international classification of diseases, ninth revision hospital discharge diagnosis codes. Clin Infect Dis. 2014;58:495–501. https://doi.org/10.1093/cid/cit780.

    Article  PubMed  Google Scholar 

  12. Desai N, Desai S, Chaddha U, Gable B. Tuberculous myopericarditis: a rare presentation in an immunocompetent host. BMJ Case Rep. 2013;2013:bcr2012007749. https://doi.org/10.1136/bcr-2012-007749.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Díaz-Peromingo JA, Mariño-Callejo AI, González-González C, et al. Tuberculous myocarditis presenting as long QT syndrome. Eur J Intern Med. 2000;11:340–2.

    Article  Google Scholar 

  14. Dogan S, Memis A, Kale A, Buket S. Endovascular stent graft placement in the treatment of ruptured tuberculous pseudoaneurysm of the descending thoracic aorta: case report and review of the literature. Cardiovasc Intervent Radiol. 2009;32:572–6. https://doi.org/10.1007/s00270-008-9456-8.

    Article  PubMed  Google Scholar 

  15. Golden MP, Vikram HR. Extrapulmonary tuberculosis: an overview. Am Fam Physician. 2005;72:1761–8.

    PubMed  Google Scholar 

  16. Golzarian J, Cheng J, Giron F, Bilfinger TV. Tuberculous pseudoaneurysm of the descending thoracic aorta: successful treatment by surgical excision and primary repair. Tex Heart Inst J. 1999;26:232–5.

    CAS  PubMed  PubMed Central  Google Scholar 

  17. Guilford T, Morris D, Gray D, Venketaraman V. Atherosclerosis: pathogenesis and increased occurrence in individuals with HIV and Mycobacterium tuberculosis infection. HIV AIDS (Auckl). 2010;2:211–8. https://doi.org/10.2147/HIV.S11977.

    Article  CAS  Google Scholar 

  18. Gupta MD, Yadav N, Palleda GM. Granulomatous tubercular myocarditis: a rare cause of heart failure in the young. Cardiol Young. 2013;23:740–1. https://doi.org/10.1017/S1047951113000723.

    Article  PubMed  Google Scholar 

  19. Huaman MA, Henson D, Ticona E, et al. Tuberculosis and cardiovascular disease: linking the epidemics. Trop Dis Travel Med Vaccines. 2015;1:10. https://doi.org/10.1186/s40794-015-0014-5.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Ikezawa T, Iwatsuka Y, Naiki K, et al. Tuberculous pseudoaneurysm of the descending thoracic aorta: a case report and literature review of surgically treated cases. J Vasc Surg. 1996;24:693–7.

    Article  CAS  Google Scholar 

  21. Irdem A, Baspinar O, Kucukosmanoglu E. Dilated cardiomyopathy due to miliary tuberculosis. Anadolu Kardiyol Derg/Anatol J Cardiol. 2013;13:499–500. https://doi.org/10.5152/akd.2013.152.

    Article  Google Scholar 

  22. Jain AK, Chauhan RS, Dhammi IK, et al. Tubercular pseudoaneurysm of aorta: a rare association with vertebral tuberculosis. Spine J. 2007;7:249–53. https://doi.org/10.1016/j.spinee.2006.04.021.

    Article  PubMed  Google Scholar 

  23. Kannangara DW, Salem FA, Rao BS, Thadepalli H. Cardiac tuberculosis: TB of the endocardium. Am J Med Sci. 1984;287:45–7.

    PubMed  Google Scholar 

  24. Karadag O, Aksu K, Sahin A, et al. Assessment of latent tuberculosis infection in Takayasu arteritis with tuberculin skin test and Quantiferon-TB Gold test. Rheumatol Int. 2010;30:1483–7. https://doi.org/10.1007/s00296-010-1444-z.

    Article  PubMed  Google Scholar 

  25. Kechaou I, Cherif E, Ben Hassine L, Khalfallah N. Deep vein thrombosis and tuberculosis: a causative link? BMJ Case Rep. 2014;2014:bcr2013200807. https://doi.org/10.1136/bcr-2013-200807.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Khemiri M, Douira W, Barsaoui S. Co-occurrence of Takayasu’s arteritis and tuberculosis: report of a Tunisian pediatric case. Ann Pediatr Cardiol. 2016;9:75–8. https://doi.org/10.4103/0974-2069.171398.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Khurana R, Shalhoub J, Verma A, et al. Tubercular myocarditis presenting with ventricular tachycardia. Nat Clin Pract Cardiovasc Med. 2008;5:169–74. https://doi.org/10.1038/ncpcardio1111.

    Article  PubMed  Google Scholar 

  28. Kolhari VB, Bhairappa S, Prasad NM, Manjunath CN. Tuberculosis: still an enigma. Presenting as mycotic aneurysm of aorta. BMJ Case Rep. 2013;2013. https://doi.org/10.1136/bcr-2013-008869.

    Google Scholar 

  29. Kothari SS. Aetiopathogenesis of Takayasu’s arteritis and BCG vaccination: the missing link? Med Hypotheses. 1995;45:227–30.

    Article  CAS  Google Scholar 

  30. Kouchoukos NT, Blackstone EH, Doty DB, et al. Pericardial disease. In: Kirklin/Barrat-Boyes cardiac surgery. 3rd ed. Philadelphia: Churchill Livingstone; 2003. p. 1779–95.

    Google Scholar 

  31. Kumarihamy K, Ralapanawa D, Jayalath W. A rare complication of pulmonary tuberculosis: a case report. BMC Res Notes. 2015;8:39. https://doi.org/10.1186/s13104-015-0990-6.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Li F-P, Wang X-F, Xiao Y-B. Endovascular stent graft placement in the treatment of a ruptured tuberculous pseudoaneurysm of the descending thoracic aorta secondary to Pott’s disease of the spine. J Card Surg. 2012;27:75–7. https://doi.org/10.1111/j.1540-8191.2011.01343.x.

    Article  PubMed  Google Scholar 

  33. Li H, Li R, Qu J, et al. Ventricular tachycardia in a disseminated MDR-TB patient: a case report and brief review of literature. Front Med. 2014;8:259–63. https://doi.org/10.1007/s11684-014-0321-7.

    Article  PubMed  Google Scholar 

  34. Lim AY, Lee GY, Jang SY, et al. Comparison of clinical characteristics in patients with Takayasu arteritis with and without concomitant tuberculosis. Heart Vessel. 2016;31:1277–84. https://doi.org/10.1007/s00380-015-0731-8.

    Article  Google Scholar 

  35. Liu A, Hu Y, Coates A. Sudden cardiac death and tuberculosis – How much do we know? Tuberculosis. 2012;92:307–13. https://doi.org/10.1016/j.tube.2012.02.002.

    Article  PubMed  Google Scholar 

  36. Long R, Guzman R, Greenberg H, et al. Tuberculous mycotic aneurysm of the aorta: review of published medical and surgical experience. Chest. 1999;115:522–31.

    Article  CAS  Google Scholar 

  37. Maisch B, Soler-Soler J, Hatle L, Ristic AD. Pericardial diseases. In: Camm AJ, Lüscher TF, Serruys P, editors. The ESC textbook of cardiovascular medicine. Blackwell Publishing; 2006. p. 517–34. Massachusetts, USA.

    Google Scholar 

  38. Mangi AA, Torchiana DF. Pericardial disease. In: Cohn LH, editor. Cardiac surgery in the adult. 3rd ed. New York: McGraw-Hill; 2008. p. 1465–78.

    Google Scholar 

  39. Manika K, Efthymiou C, Damianidis G, et al. Miliary tuberculosis in a patient with tuberculous mycotic aneurysm of the abdominal aorta: case report and review of the literature. Respir Med Case Rep. 2017;21:30–5. https://doi.org/10.1016/j.rmcr.2017.03.010.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Mayosi BM, Burgess LJ, Doubell AF. Tuberculous pericarditis. Circulation. 2005;112:3608–16. https://doi.org/10.1161/CIRCULATIONAHA.105.543066.

    Article  PubMed  Google Scholar 

  41. Michira BN, Alkizim FO, Matheka DM. Patterns and clinical manifestations of tuberculous myocarditis: a systematic review of cases. Pan Afr Med J. 2015;21:118. https://doi.org/10.11604/pamj.2015.21.118.4282.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Mohan A, Thachil A, Sundar G, et al. Ventricular tachycardia and tuberculous lymphadenopathy: Sign of myocardial tuberculosis? J Am Coll Cardiol. 2015;65:218–20.

    Article  Google Scholar 

  43. Mutyaba AK, Ntsekhe M. Tuberculosis and the heart. Cardiol Clin. 2017;35:135–44. https://doi.org/10.1016/j.ccl.2016.08.007.

    Article  PubMed  Google Scholar 

  44. Nezami N, Ghorbanihaghjo A, Rashtchizadeh N, et al. Atherogenic changes of low-density lipoprotein susceptibility to oxidation, and antioxidant enzymes in pulmonary tuberculosis. Atherosclerosis. 2011;217:268–73. https://doi.org/10.1016/j.atherosclerosis.2011.03.025.

    Article  CAS  PubMed  Google Scholar 

  45. Ntsekhe M, Wiysonge CS, Commerford PJ, Mayosi BM. The prevalence and outcome of effusive constrictive pericarditis: a systematic review of the literature. Cardiovasc J Afr. 2012;23:281–5. https://doi.org/10.5830/CVJA-2011-072.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Ohtsuka T, Kotsuka Y, Yagyu K, et al. Tuberculous pseudoaneurysm of the thoracic aorta. Ann Thorac Surg. 1996;62:1831–4.

    Article  CAS  Google Scholar 

  47. Palaniswamy C, Kumar U, Selvaraj DR, et al. Tuberculous mycotic aneurysm of aortic root: an unusual cause of cardiac tamponade. Trop Dr. 2009;39:112–3. https://doi.org/10.1258/td.2008.080199.

    Article  Google Scholar 

  48. Parkhurst GF, Dekcer JP. Bacterial aortitis and mycotic aneurysm of the aorta; a report of twelve cases. Am J Pathol. 1955;31:821–35.

    CAS  PubMed  PubMed Central  Google Scholar 

  49. Pathirana U, Kularatne S, Karunaratne S, et al. Ascending aortic aneurysm caused by Mycobacterium tuberculosis. BMC Res Notes. 2015;8:659. https://doi.org/10.1186/s13104-015-1667-x.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Rajesh S, Sricharan KN, Jayaprakash K, Monteiro FNP. Cardiac involvement in patients with pulmonary tuberculosis. J Clin Diagn Res. 2011;5:440–2.

    Google Scholar 

  51. Reuter H, Burgess L, van Vuuren W, Doubell A. Diagnosing tuberculous pericarditis. QJM. 2006;99:827–39. https://doi.org/10.1093/qjmed/hcl123.

    Article  CAS  PubMed  Google Scholar 

  52. Rota S, Rota S. Mycobacterium tuberculosis complex in atherosclerosis. Acta Med Okayama. 2005;59:247–51.

    CAS  PubMed  Google Scholar 

  53. Roubille F, Gahide G, Granier M, et al. Likely tuberculous myocarditis mimicking an acute coronary syndrome. Intern Med. 2008;47:1699–701.

    Article  Google Scholar 

  54. Silingardi E, Rivasi F, Santunione AL, Garagnani L. Sudden death from tubercular myocarditis. J Forensic Sci. 2006;51:667–9. https://doi.org/10.1111/j.1556-4029.2006.00117.x.

    Article  PubMed  Google Scholar 

  55. Soto ME, Del Carmen Ávila-Casado M, Huesca-Gómez C, et al. Detection of IS6110 and HupB gene sequences of Mycobacterium tuberculosis and bovisin the aortic tissue of patients with Takayasu’s arteritis. BMC Infect Dis. 2012;12:194. https://doi.org/10.1186/1471-2334-12-194.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Soto ME, Vargas-Alarcón G, Cicero-Sabido R, et al. Comparison distribution of HLA-B alleles in Mexican patients with Takayasu arteritis and tuberculosis. Hum Immunol. 2007;68:449–53. https://doi.org/10.1016/j.humimm.2007.01.004.

    Article  CAS  PubMed  Google Scholar 

  57. Trautner BW, Darouiche RO. Tuberculous pericarditis: optimal diagnosis and management. Clin Infect Dis. 2001;33:954–61. https://doi.org/10.1086/322621.

    Article  CAS  PubMed  Google Scholar 

  58. Vaideeswar P, Deshpande JR. Pathology of Takayasu arteritis: a brief review. Ann Pediatr Cardiol. 2013;6:52–8. https://doi.org/10.4103/0974-2069.107235.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Walters HM, Aguiar CL, MacDermott EJ, et al. Takayasu arteritis presenting in the context of active tuberculosis. J Clin Rheumatol. 2013;19:344–7. https://doi.org/10.1097/RHU.0b013e31829ce750.

    Article  PubMed  Google Scholar 

  60. Zhang C, Chen B, Gu Y, et al. Tuberculous abdominal aortic pseudoaneurysm with renal and vertebral tuberculosis: a case and literature review. J Infect Dev Ctries. 2014;8:1216–21.

    Article  Google Scholar 

  61. Zhang Y, Xiong Q, Hu X, et al. A novel atherogenic epitope from Mycobacterium tuberculosis heat shock protein 65 enhances atherosclerosis in rabbit and LDL receptor-deficient mice. Heart Vessel. 2012;27:411–8. https://doi.org/10.1007/s00380-011-0183-8.

    Article  Google Scholar 

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Aşgün, H.F., Kırılmaz, B. (2019). Cardiovascular Tuberculosis. In: Sener, A., Erdem, H. (eds) Extrapulmonary Tuberculosis. Springer, Cham. https://doi.org/10.1007/978-3-030-04744-3_12

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