Systemic diseases and their diagnosis with echocardiography

Systemic diseases are disorders that are not limited to one organ, but involve **several organs or body systems**. These diseases usually have **extensive symptoms** and can simultaneously affect the skin, joints, kidneys, heart, lungs, and other organs. Among known systemic diseases, we can mention "lupus, rheumatoid arthritis, diabetes, sarcoidosis, amyloidosis, and scleroderma." Their symptoms vary depending on the type of disease and the organs involved, but usually include chronic fatigue, fever, joint pain, skin rashes, and heart or kidney problems. Diagnosis of these diseases is complex and requires a careful clinical examination, blood tests, imaging (such as MRI or CT), and sometimes a biopsy. Many of these diseases can affect the **heart**; Such as inflammation of the pericardium, disorder in the heart muscle or valves, which can be diagnosed with tools such as echocardiography. Treatment usually includes **anti-inflammatory, immunosuppressive, or hypoglycemic drugs**, and ongoing medical follow-up is key. Echocardiography and diagnosis of systemic diseases **Systemic diseases** usually may directly or indirectly damage the **heart**. In this case, echocardiography is considered a very important tool for diagnosing and monitoring cardiac involvement: ### **Checking the thickness and structure of the heart muscle** In diseases such as **amyloidosis or sarcoidosis**, the deposition of abnormal substances in the heart muscle leads to **increasing the thickness of the walls and reducing flexibility**. These changes are clearly visible in the echo. ### Examination of the pericardium In **lupus or rheumatoid arthritis**, **pericarditis (inflammation of the heart membrane)** or **accumulation of fluid around the heart** may occur, and echocardiography is the most accurate method to diagnose these conditions. ### Evaluation of the function of the ventricles Many systemic diseases such as **diabetes** or **scleroderma** can cause left or right ventricular dysfunction (e.g. reduced EF or diastolic dysfunction). Echo shows these things well. ### Diagnosis of valvular disorders Some systemic diseases cause damage or inflammation of heart valves. For example, in lupus, the valves may become "thickened or leaky", which can be detected by echo. ### Diagnosis of arrhythmia and indirect heart blocks In cases such as **cardiac sarcoidosis**, which causes disturbances in the electrical conduction of the heart, echo can be helpful in diagnosing the underlying causes of arrhythmia, although ECG and Holter are also used. types of echocardiography used in systemic diseases 1. Transthoracic echocardiography (TTE): the most common type; It is done from the chest. 2. **Transesophageal echocardiography (TEE):** for a more detailed view of the internal structures of the heart. 3. **Stress Echo:** **Stress Echo**, examination of heart function during activity or drug stimulation, useful in **diabetic patients**. 4. **3D Echo:** More details to check the structure of valves and ventricles. Advantages of echocardiography in systemic patients - Non-invasive and painless - No radiation and safe even during pregnancy - Can be repeated to check the treatment process or the progress of the disease - Fast and can be done in a clinic or hospital **Systemic diseases, symptoms and effects on the heart and ways to diagnose them** ### **Lupus (SLE)** - **Introduction:** An autoimmune disease that can affect the skin, joints, kidney, brain and heart. - **Symptoms:** butterfly rash on the face, fatigue, joint pain, fever, hair loss. - **Effect on the heart:** Pericarditis, myocarditis, valve inflammation. - **Diagnosis:** ANA test, anti-dsDNA, CBC, echocardiography, urine test. ### **Rheumatoid Arthritis (RA)** - **Introduction:** Chronic autoimmune disease that mostly affects small joints but is systemic. - **Symptoms:** Pain, swelling and dryness of joints, fever, fatigue. - **Effect on the heart:** pericarditis, increased risk of atherosclerosis and **heart failure**. - **Diagnosis:** RF, Anti-CCP, ESR, CRP, joint imaging, sometimes echocardiography. ### **Diabetes mellitus (type 1 and 2)** - **Introduction:** Disturbance in blood sugar regulation due to insulin deficiency or resistance. - **Symptoms:** Excessive thirst, frequent urination, fatigue, weight loss. - **Effect on the heart:** high risk for coronary heart disease, **heart failure** and **cardiomyopathy**. - **Diagnosis:** Fasting blood sugar, HbA1c, fat test, echocardiography if needed. ### **Amyloidosis** - **Introduction:** Deposition of abnormal proteins (amyloid) in organs, especially heart, kidney and liver. - **Symptoms:** Swelling of legs, shortness of breath, fatigue, changes in blood pressure. - **Effect on the heart:** Stiffness and thickening of the heart muscle, diastolic failure. - **Diagnosis:** Heart MRI, echocardiography, biopsy, serum protein electrophoresis. ### **Sarcoidosis** - **Introduction:** Inflammatory disease with the formation of granulomas in the lungs, eyes, skin and sometimes the heart. - **Symptoms:** Chronic cough, skin lesions, joint pain, blurred vision. - **Effect on the heart:** Arrhythmia, heart block, cardiomyopathy. - **Diagnosis:** CT, cardiac MRI, granuloma biopsy, serum ACE enzyme, echocardiography in some cases. ### **Scleroderma (Systemic Sclerosis)** - **Introduction:** Autoimmune disease with skin stiffness and involvement of blood vessels and internal organs. - **Symptoms:** Skin stiffness and darkness, Raynaud's phenomenon, digestive problems, shortness of breath. - **Effect on the heart:** Cardiac fibrosis, ventricular dysfunction, arrhythmia. - **Diagnosis:** ANA, anti-Scl-70, echocardiography, lung HRCT, pulmonary function test.