Involvement of the heart by small and medium vessel vasculitis.

PURPOSE OF REVIEW: The heart may be involved in many different ways by the systemic vasculitides. In this review, we focus on recently described diagnostic and therapeutic issues in small and medium vessel vasculitis of the heart. RECENT FINDINGS: Data have emerged on the prevalence and significance of cardiac involvement in the systemic vasculitides. There is an increasing array of sophisticated imaging modalities including echocardiography, PET, and cardiac MRI that aid in the clinical diagnosis. SUMMARY: Most small and medium vessel vasculitides may involve the heart; however, the mode and incidence of cardiac involvement vary with the different vasculitic syndromes. This review describes the various cardiac manifestations of small and medium vessel vasculitis and the advantages of modern imaging modalities including echocardiography, MRI, and PET coupled with biologic biomarkers such as brain natriuretic peptide and antineutrophilic cytoplasmic antibodies in the diagnosis and management of disease.