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Cardiovascular involvement in systemic lupus erythematosus.

B F Mandell1

  • 1Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia.

Seminars in Arthritis and Rheumatism
|November 1, 1987
PubMed
Summary

Systemic lupus erythematosus (SLE) frequently affects the cardiovascular system, causing conditions like pericarditis and Libman-Sacks endocarditis. Vigilant management of contributing factors and rare complications is crucial for patient outcomes.

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Area of Science:

  • Rheumatology
  • Cardiology
  • Immunology

Background:

  • Systemic lupus erythematosus (SLE) is a multisystem inflammatory disease of unknown cause.
  • Cardiovascular involvement is common in SLE, though often subclinical.
  • Potential cardiac manifestations range from pericarditis and endocarditis to coronary artery disease and cardiomyopathy.

Purpose of the Study:

  • To review the spectrum of cardiovascular involvement in SLE.
  • To highlight the clinical significance and management of these complications.
  • To emphasize the importance of managing risk factors for cardiovascular disease in SLE patients.

Main Methods:

  • Literature review of cardiovascular manifestations in SLE.
  • Analysis of clinical presentations and pathological findings.

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  • Discussion of therapeutic strategies and risk factor management.

    • Main Results:

    • Pericarditis is common, often subclinical, but can lead to tamponade.
    • Libman-Sacks endocarditis may necessitate valve replacement despite lack of murmurs.
    • Increased incidence of ischemic coronary disease due to atherosclerosis and arteritis.
    • Congenital heart block associated with maternal anti-Ro antibodies.
    • Evidence suggests mild SLE-associated cardiomyopathy from microvascular disease.
    • Acute myocarditis and conduction abnormalities are rare but significant.

    Conclusions:

    • Cardiovascular complications in SLE are frequent and varied, requiring careful monitoring.
    • Management should focus on limiting risk factors (hypertension, hypercholesterolemia, smoking, steroids) and recognizing rare but serious cardiac events.
    • Aggressive treatment of systemic hypertension is paramount.