Invasive techniques—from diagnosis to treatment
1Department of Internal Medicine and Cardiology, University Hospital of Gießen and Marburg, Philipps-University Marburg, Germany and 1Department of Cardiology, Institute for Cardiovascular Diseases of the Clinical Centre of Serbia and Belgrade University School of Medicine, Belgrade, Serbia
Correspondence to: Prof. Bernhard Maisch, MD, FESC, FACC, Director of the Department of Internal Medicine and Cardiology, Dean of the Medical Faculty, University Hospital of Gießen and Marburg, Baldingerstr, 35043 Marburg, Germany. E-mail: Bernhard.Maisch{at}med.uni-marburg.de; BerMaisch{at}aol.com
Invasive diagnostic and therapeutic techniques are indispensable for the diagnosis and interventional treatment of coronary artery disease, valvular involvement and, in particular, if the specific components of the inflammatory or degenerative processes in rheumatic disease are to be identified in the different components of the heart. Although impairment of cardiac function and ischaemia can be suspected also by non-invasive techniques, coronary involvement needs the final proof by angiography. Endomyocardial or epicardial biopsy identifies the key players of autoreactivity: the infiltrating cells and the bound and circulating antibodies. Before corticoid treatment is started, a viral or microbial aetiology has to be excluded at the site of cardiac inflammation. This again can only be done by the analysis of cardiac tissue samples.