Cardiac Lesions in Behcet Disease

Cardiac lesions in Behcet disease

There could be protean manifestations of cardiac involvement in Behcet disease, with poor prognosis. All the three layers could be involved, including pericarditis, myocarditis and endocarditis. Valvular regurgitation can occur as part of the endocardial involvement. Coronary arteritis with or without myocardial infarction, intracardiac thrombi and even endomyocardial fibrotic lesions have been described in Behcet’s disease. Aneurysms can occur in the coronary arteries and in the aortic sinuses of Valsalva.

Geri G et al reported on 52 patients with cardiac lesions from a total of 807 patients with Behcet disease [1]. 86.5% patients were male with a mean age of 29.3 years at diagnosis. Initial presentation as cardiac involvement was noted in 32.7% of patients of those with cardiac lesion. Pericarditis was the commonest (38.5%). Endocardial involvement (26.9%) mostly manifested as aortic regurgitation. Intracardiac thrombi were noted in 19.2%.

Oral anticoagulants, immunosuppressants, and colchicine were used in the treatment of Behcet disease with cardiac involvement [1]. It may be noted that Behcet’s disease is a multi system disease with an autoimmune basis. Five year survival was reduced in those with cardiac involvement (83.6%) compared to 95.8% in those without cardiac involvement. Though the prognosis with cardiac involvement was not good, it became better with oral anticoagulation, immunosuppressants and colchicine.

Reference

1. Guillaume Geri, Bertrand Wechsler, Du Le Thi Huong, Richard Isnard, Jean-Charles Piette, Zahir Amoura, Mathieu Resche-Rigon, Patrice Cacoub, David Saadoun. Spectrum of Cardiac Lesions in Behcet Disease: A Series of 52 Patients and Review of the Literature. Medicine (Baltimore). 2012 Jan;91(1):25-34.