Zusammenfassung
Obwohl eine kardiale Beteiligung bei immunologischen Erkrankungen in der Regel mit einer schlechten Prognose assoziiert ist, wird sie oftmals übersehen. Häufige Manifestationen sind Myokarditiden, Perikarditiden, Rhythmusstörungen, Vaskulitiden oder eine koronare Herzkrankheit. Ein generelles Screening auf kardiovaskuläre Beteiligungen ist in den Leitlinien nicht vorgesehen und erscheint angesichts der geringen Häufigkeit bei den meisten immunologischen Erkrankungen auch nicht sinnvoll. Jedoch sollte bei geringsten kardialen Symptomen eine eingehende Untersuchung inklusive der Bestimmung von Troponin und NT-pro-BNP, Elektrokardiogramm, Echokardiografie und Kardio-MRT erfolgen. Je nach Verfügbarkeit und Grunderkrankung sollten zusätzlich eine PET-CT oder eine kombinierte PET-MRT und/oder eine Myokardbiopsie durchgeführt werden. Der Nachweis einer kardialen Beteiligung zieht in der Regel eine Intensivierung der Therapie, insbesondere der Immunsuppression, nach sich.
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Könemann, S., Dörr, M., Felix, S.B. (2023). Kardiale Beteiligung bei immunologischen Erkrankungen. In: Marx, N., Erdmann, E. (eds) Klinische Kardiologie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-62932-1_32
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