Monday, 25 June 2012

Tuberculosis is capable of attacking the heart muscle, making it enlarged and puffy and causing fast irregular heart beat

By Syed Akbar
Hyderabad: A team of city doctors has found that tuberculosis
is capable of attacking the heart muscle, making it enlarged and puffy
and causing fast irregular heart beat. Earlier, it was thought that
tuberculosis does not attack the heart muscle but causes damage to the
outer layer. The finding by city doctors, however, negates this
age-old medical belief. The damage to the heart muscle by myocardial
tuberculosis often leads to sudden death.

“Our scientific work involved studying myocardial tuberculosis causing
heart rhythm disorder called ventricular tachycardia. This is a
serious life-threatening disorder leading to blackouts and even sudden
cardiac arrest and death. Treatment often requires expensive devices
as medicines are not fully protective. We have identified a cohort of
patients in whom tuberculosis of the heart muscle has been responsible
for this condition. This is the largest spectrum of such patients in
the world,” said Dr K Sarada, cardiologist and electro-physiologist,
Care Hospital. Dr Sarada and her team for the first time noticed that
tuberculosis is capable of damaging the heart muscle.

The problem, if detected early, can be reversed through a combination
of anti-TB drug therapy and immuno-suppressant drugs, she said adding
that as many as 70 per cent of the patients recovered. The enlarged
and puffy heart as also the rhythm became normal.

The study was presented at the plenary session of the prestigious Heart Rhythm

Society at Boston, USA held in May. Dr C Narasimhan and Dr C Sridevi are
the other two members of the research team.

The team also found that besides myocardial tuberculosis, patients
with cardiac sarcoidosis are at increased risk for sudden death from
ventricular arrhythmias (irregular heart rhythm).  In this
multi-center retrospective cohort study of 235 patients, the
researchers found that patients with cardiac sarcoidosis and
implantable cardiac assist devices (ICDs) were at high risk for
ventricular arrhythmias, with 36 per cent of patients receiving an
appropriate ICD therapy over a mean follow-up of 4.2 years.

Patients also had high rates of inappropriate shocks and
device-related complications. Patients receiving appropriate therapies
were more likely to be male, have a history of syncope (loss of
consciousness), have a lower left ventricular ejection fraction, have
had the ICD implanted for secondary prevention, and have ventricular
pacing on baseline ECG.

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