Cardiac involvement in XXXX : evolving concepts in diagnosis and treatment.

@entity1 @entity1164 @entity296 @entity419 @entity944 @entity2287 @entity299 @entity8526 @entity370 @entity943 @entity616 @entity288
Clinically evident @entity370 involving the heart has been noted in at least 2 to 7% of @entity1 with @entity370 , but occult involvement is much higher (> 20%). @entity299 is often not recognized antemortem, as @entity944 may be the presenting feature. Cardiac involvement may occur at any point during the course of @entity370 and may occur in the absence of pulmonary or systemic involvement. @entity370 can involve any part of the heart, with protean manifestations. Prognosis of @entity299 is related to extent and site(s) of involvement. Most deaths due to @entity299 are due to @entity943 or @entity8526 , but granulomatous infiltration of the myocardium may be lethal. The definitive diagnosis of isolated @entity299 is difficult. The yield of endomyocardial biopsies is low; treatment of @entity299 is often warranted even in the absence of histologic proof. Radionuclide scans are integral to the diagnosis. Currently, @entity419 positron emission tomography/computed tomography and @entity2287 -enhanced magnetic resonance imaging scans are the key imaging modalities to diagnose @entity299 . The prognosis of @entity299 is variable, but mortality rates of untreated @entity299 are high. Although randomized therapeutic trials have not been done, @entity288 (alone or combined with additional immunosuppressive medications) remain the mainstay of treatment. Because of the potential for @entity1164 , implantable cardioverter-defibrillators should be placed in any @entity1 with @entity299 and serious @entity943 or @entity616 , and should be considered for @entity296 . Cardiac transplantation is a viable option for @entity1 with end-stage @entity299 refractory to medical therapy.
