-
Systemic Lupus Erythematosus
The Heart
-
Systemic Lupus Erythematosus
Multisystem disease Immune system Constitutional Fever;
fatigue
Skin and mucosa
Joints
Kidneys
Heart
Nervous system
Blood
-
Systemic Lupus ErythematosusHeart
PericardiumPericarditisPericardial effusion
Pericardial tamponade Myocardium
Myocarditis Cardiomyopathy
EndocardiumValvular
Coronary artery diseaseVasculitis
AtherosclerosisAntiphospholipid syndrome
Hypertension
-
Systemic Lupus Erythematosus
Coronary Artery disease Risk Factors
Male Age Family History Smoking High cholesterol
SLE
-
Systemic Lupus ErythematosusCoronary Artery Disease
Compared to the general population 50 times more common in
premenopausal
woman with lupus
MI may the first presenting sign of CAD
MI occurs at an earlier Mean age 49 compared to 69 in the
general female
population
-
Systemic Lupus ErythematosusChest pain
Musculoskeletal Trauma; muscle strain ; Rib fracture
Trauma or osteoporotic (steroids)
Pericarditis Pleuritis Referred pain
Abdomen eg. gall bladder Nerve root Cervical spine Zoster
Myocardial Infarction
-
Systemic Lupus ErythematosusPericarditis
May be the initial manifestation of SLE
Could be recurrent
Chest pain from mild to very severe
Increased with inspiration and bending forward
EKG abnormalities
Viral pericarditis usually preceded by URI
-
Systemic Lupus ErythematosusPericarditis Treatment
Pericarditis NSAID
Indomethacin Narcotics
Pericardial Effusion Small
no treatment
Large Trial of steroids
Tamponade pericardiocentesis
-
Systemic Lupus ErythematosusCardiomyopathy
Unexplained Rapid heart rate Increasing shortness of breath
Difficulty sleeping flat Cough Swollen feet
-
Systemic Lupus Erythematosus Cardiomyopathy
Inflammatory Ischemic Others
Drugs eg. Chloroquine
-
Systemic Lupus ErythematosusFatigue
Common symptom of
Lupus Depression Ischemic heart disease Fibromyalgia
Associated with poor sleep pattern
Depression
Multiple tender points
-
Systemic Lupus ErythematosusCoronary Artery Disease
Diet Exercise Stop smoking Statins Hydroxychloroquine
Part of standard treatment of Lupus May prevent flares
May reduce Cholesterol levels
Keep steroids at the lowest possible dose Treatment of
hypertension
-
Systemic Lupus ErythematosusEndocarditis
Non Infectious Libman Sacks
Verrucous vegetations at the end of the valve Complement and
fibrin deposition Associated with APL
Mitral and aortic valve
Rarely causes hemodynamic changes Rupture of the chordae
Thromboembolic phenomenon
-
Antiphospholipid Syndrome
Recurrent spontaneous abortions Deep vein or arterial
thrombosis
Treatment includes life time anticoagulation
