RT Journal Article
SR Electronic
T1 Should the respiratory physician be familiar with endomyocardial biopsy?
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P3660
VO 44
IS Suppl 58
A1 Jenny Louise Bacon
A1 Praveen Kumar Molanguri
A1 Francois J. Raphael
A1 Brendan Madden
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P3660.abstract
AB Background We are the UK national centre for non-transplant endomyocardial (EM) biopsy. Cardiac involvement has important clinical, therapeutic and prognostic implications for patients with multisystem diseases and is often associated with significant morbidity and mortality.Aim To review patients with associated respiratory illness undergoing EM biopsy.MethodRetrospective analysis of all EM biopsies performed over 20 months. Procedure indications, histopathology results and complications were reviewed. All patients with associated respiratory complaints were identified. EM biopsies were taken from the right ventricular septum via the right internal jugular vein under strict asepsis and 2D echocardiographic guidance.Results40 EM biopsies were performed in 32 males aged 23-82 years. The most common indication was cardiac amyloidosis investigation (25 patients, 14(56%) positive histology). 5 patients with respiratory disease had EM biopsy to assess for associated cardiac involvement. 1 patient originally presented with eosinophilic pleural effusions and cardiac failure. EM biopsy later confirmed eosinophilic myocarditis. 4 patients had EM biopsy confirming cardiac sarcoid (3(75%) positive). The median procedure time was 25 minutes. The only complication was ventricular tachycardia in one patient which was successfully cardioverted.DiscussionIn this study cohort 5 patients undergoing EM biopsy(13%) had associated respiratory disease and the biopsy provided a diagnosis in 4 patients. The respiratory physician should be aware of the diagnostic option for right ventricular biopsy under local anaesthetic and the safety of performing EM biopsy in experienced hands.