The Intersection of Tuberculosis and Cardiovascular Disease: A Systematic Review
Background:Tuberculosis is one of the oldest infectious diseases known to affect every organ and tissue of the human body and the heart is no exception. However,cardiac manifestations of tuberculosis (TB) are not given enough attention in clinical practice in developing countries where intersection of the two epidemics are observed.
Objectives: The goal of this clinical review is assess the cardiovascular manifestations of TB and to restore awareness among clinicians to promote high index of suspicion for early diagnosis and thereby timely management of various forms of cardiovascular tuberculosis.
Materials and Methods:Literature search for published evidence on cardiovascular complications of tuberculosis was conducted on MEDLINEandCochrane collaboration and the Cochrane Register of Controlled Trials (inclusive from 1980-2017). The following search terms were used:Disseminated tuberculosis, tuberculous pericarditis, intracardiactuberculoma, tuberculous endocarditis, myocardial TB, tuberculosis of blood vessels, Takayasu arteritis (TA)
Results and Discussion: The spectrum of cardiovascular complications of TB include pericarditis, myocardial involvement, intracardiactuberculoma, and involvement of the blood vessels including coronary arteries with various manifestations ranging from no symptoms to sudden cardiac death.
Conclusion:Although TB can involve the heart and the blood vessels including coronaries, the diagnosis of cardiovascular TB remains challenging without high index of suspicion.The treatment of cardiovascular TB is primarily antituberculous chemotherapy and surgical intervention is rarely required.There is no robust evidence as to the potential association between TB and TA.
Key words: Tuberculosis, pericarditis, myocarditis, intracardiactuberculoma, endocarditis,Takayasu arteritis
Global tuberculosis report 2017. Geneva: World Health Organization; 2017. Licence: CC BY-NCSA 3.0 IGO.
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