Cardiovascular manifestations of systemic and chronic disease

At a glance

• Many systemic diseases reach the heart. The exam tests the pairing: the disease, its typical cardiac lesion and the clue that links them.
• Think systemic disease when a young patient has conduction disease, when hypertrophy and ECG voltages don't match, when right-sided valves are diseased without a reason, or when heart failure comes with carpal tunnel, neuropathy or proteinuria.
• Management is mostly the standard cardiac treatment plus control of the underlying disease. The traps lie in the exceptions: dialysis for uraemic pericarditis, ICD rather than pacemaker in sarcoid, chemotherapy for AL amyloid.