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Systemic Lupus Erythematosus The Heart

Systemic Lupus Erythematosus Heart

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Text of Systemic Lupus Erythematosus Heart

  • 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