Aim of the study is to determine the prevelance of subclinical cardiac involvement in patients with inflamatory bowel disease.

Cardiovascular manifestations in patients with IBD mostly occur as immune-related consequences and include the following: pericarditis, myocarditis, venous and arterial thromboembolism, left ventricle impairment, arrhythmias and conduction disorders and valvulopathy .

The prevalence of classical cardiovascular risk factors is relatively lower in IBD patients than in the general population . However, the risk of coronary heart disease is higher in IBD patients .

The pathophysiology of cardiac involvement may be Systemic inflammation for prolonged periods that can cause platelet aggregation and endothelial dysfunction leading to the development of atherosclerosis and CVD .

The chronic inflammatory condition found in IBD is the key element in the pathogenesis of arrhythmias.

In IBD, inflammation causes mitral and aortic valvulopathies , excess TNF-α causes the thickening and shortening of the leaflets, resulting in regurgitation .

Medications of IBD may be involved in pathogenesis of cardiac involvement as follows 5-ASA and its derivatives can cause myopericarditis . Atrial fibrillation and prolonged QT interval may occur during azathioprine use .

Cyclosporine is associated with increased risk of hypertension, arrhythmias, acute coronary syndrome, and heart failure .

Biological molecules are associated with increased arrhythmogenic risks . Primary preventive measures of arterial thromboembolism include maintaining the remission, strict control of cardiovascular risk factors .

The diagnostic modalities to find out cardiac involvement include; The 12-lead electrocardiogram . Transthoracic echocardiography which represent the method of choice to evaluate both systolic and diastolic functions of Lt ventricle.

Methodology:

All Patints will be subjected to the followings :

Full history taking including

• Duration of illness
• Symptoms of disease activity
• Symptoms of extraintestinal manifestation
• Family history of cardiac disease
• History of traditional cardiovascular risk factors diabetes,hypertension,Dyslipidaemia,cigarette smooking)
• Therapeutic history Examination
• Body mass index.
• Vital signs( pulse,blood pressure,temperature).
• Cardiac examination.

Labaratory investigations

• Complete blood count - serum electrolytes
• ESR - CRP
• lipid profile - blood glucose level
• TSH,T3,T4

ECG

• Ischaemic changes
• Any type of arrythmia
• Prolonged QT interaval

Holter ECG

Echocardiography

• Systolic and diastolic dysfunctions
• Wall motion abnormalities
• Valvular heart disease
• Ventricular hypertrophy
• Atrial and ventricular dimentions

Inclusion Criteria:

• Inflamatory bowel disease patients without previous history of cardiac disease.

Exclusion Criteria:

• Patients known to have previous cardiac disease.

IBD patients who have no previous history of cardiac disease.