Cardiovascular Complications in Tuberculosis

Objective: The main aim of this literature review is to summarize recent scientific literature on cardiac involvement in tuberculosis, epidemiology, clinical presentation and possible outcomes. Methods: A literature review was performed using PubMed, Scopus and Google Scholar databases from 2015 onwards using keywords such as “tuberculosis”, “cardiac complications”, “pericarditis”, “myocarditis”, “endocarditis”, “aortitis”, “cardiovascular diseases” and “antituberculous drugs cardiotoxic effect”. Results: The most frequently reported tuberculosis cardiac manifestation is pericarditis, and it may present with fever, dyspnea, cough or increased central venous pressure, hepatomegaly and peripheral edema. Tuberculous pericarditis treatment is challenging due to the limited penetration of antituberculous drugs into the pericardium. Myocarditis is another form, often associated with arrhythmias. Tuberculous aortitis typically causes dilatation leading to pseudoaneurysm formation and is usually asymptomatic, but it can rarely result in sepsis, aortic rupture or even death. Cardiac tuberculomas may present with general symptoms and can impair heart function by obstructing the outflow tracts, leading to ventricular dysfunction. Additionally, the primary treatment of tuberculosis carries cardiotoxicity risks, such as various arrhythmias. Moreover, tuberculosis significantly increases the risk of cardiovascular conditions, including myocardial infarction and coronary artery obstruction. Therefore, early diagnosis and a multidisciplinary approach are crucial to prevent severe outcomes such as sudden cardiac death, sepsis, or aortic rupture. Conclusions: Cardiac involvement in tuberculosis is relatively rare, with pericarditis being the most frequently reported manifestation. Early diagnosis and multidisciplinary healthcare are essential for cardiac complications of tuberculosis to save patients from fatal outcomes.