Elmati PR, Jagirdhar GSK, Surani S. Cardiac implications in myasthenia gravis. World J Clin Cases 2024; 12(26): 5863-5867 [DOI: 10.12998/wjcc.v12.i26.5863]
Corresponding Author of This Article
Salim Surani, FACP, FCCP, MD, MHSc, Adjunct Professor, Department of Medicine and Pharmacology, Texas A&M University, 40 Bizzell Street, College Station, TX 77843, United States. srsurani@hotmail.com
Research Domain of This Article
Medicine, General & Internal
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 16, 2024; 12(26): 5863-5867 Published online Sep 16, 2024. doi: 10.12998/wjcc.v12.i26.5863
Cardiac implications in myasthenia gravis
Praveen Reddy Elmati, Gowthami Sai Kogilathota Jagirdhar, Salim Surani
Praveen Reddy Elmati, Department of Anesthesiology, Saint Clair Hospital, Dover, NJ 07801, United States
Gowthami Sai Kogilathota Jagirdhar, Department of Medicine, Saint Michaels Medical Center, Newark, NJ 07107, United States
Salim Surani, Department of Medicine and Pharmacology, Texas A&M University, College Station, TX 77843, United States
Author contributions: Elmati PR designed the overall concept and outline of the manuscript; Elmati PR and Kogilathota Jagirdhar GS performed the research and literature review; Elmati PR, Kogilathota Jagirdhar GS, and Surani S analyzed the studies and wrote the manuscript; All authors have read and approved the final manuscript.
Conflict-of-interest statement: None of the authors have any conflict of interest to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: Https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Salim Surani, FACP, FCCP, MD, MHSc, Adjunct Professor, Department of Medicine and Pharmacology, Texas A&M University, 40 Bizzell Street, College Station, TX 77843, United States. srsurani@hotmail.com
Received: May 5, 2024 Revised: June 3, 2024 Accepted: June 14, 2024 Published online: September 16, 2024 Processing time: 75 Days and 20.3 Hours
Abstract
This editorial aimed to consolidate the current evidence in literature on the association between myasthenia gravis (MG) and cardiac involvement, focusing on the impact of thymoma, antistriational antibodies, and late-onset MG. Additionally, the study aimed to explore the influence of genetic differences among populations on the association with cardiac disease. We conducted a review of existing literature in PubMed and Google Scholar to find relevant studies on cardiac involvement in MG. We created search criteria using a combination of free text words, including MG, antistriational antibodies, thymectomy, cardiomyopathy, myocarditis, arrhythmias, autonomic dysfunction. Relevant articles published in English language were analyzed and incorporated. The findings indicate a strong association between thymoma, myasthenic crisis, antistriational antibodies, and late-onset MG with cardiac involvement. The study also revealed that genetic differences among populations influence the risk of cardiac disease and electrocardiography (ECG) abnormalities in MG patients. Autonomic dysfunctions altered cardiac autonomic response and increased susceptibility to arrhythmias and sudden cardiac death in MG patients. The study supports the significance of thymoma, antistriational antibodies, and late-onset MG as key factors associated with cardiac involvement in MG patients. It emphasizes the importance of ECG as the initial test in managing MG patients, particularly in the perioperative period, to identify and genetic testing if needed to address their cardiac risk effectively.
Core Tip: Preoperative cardiac screening is crucial for patients with myasthenia gravis (MG), especially those with thymoma, late-onset MG, or antistriational antibodies. Understanding the link between MG and cardiac conditions such as cardiomyopathy, myocarditis, takotsubo cardiomyopathy, autonomic dysfunction, and arrhythmias is essential for perioperative surgical management. Electrocardiography and Troponin T can be important initial screening tests in patients with high risk suspicion. Comprehensive screening protocols are necessary to mitigate cardiac risks and optimize outcomes in MG patients undergoing surgery.
