LUPUS & HEART HEALTH Niharika Sharma MD Rheumatologist | Akron General Cleveland Clinic
INTRODUCTION Lupus is a multi-organ autoimmune disease, commonly affecting young women of childbearing age. Classically, the involvement of kidneys (lupus nephritis) led to a more severe course in the disease. However, with the advancements in the diagnosis and treatment of lupus, kidney related complications have lessened. In fact, the involvement of heart and vascular systems have become prominent and often lead to increased suffering in lupus patients. Both stroke and myocardial infarction (“heart attack”) occur more frequently in premenopausal women with lupus compared with their counterparts. This makes up 30% of premature deaths in the first 5 years after diagnosis of lupus. The prevalence of coronary artery disease in lupus patients
18
LIVING WITH LUPUS MAGAZINE
is 10-fold higher as compared to the general population and 50-fold higher in young women of childbearing age. CLINICAL PRESENTATION Lupus can affect the heart in several ways, pericarditis, or inflammation of the outer lining of the heart being the most common. Approximately 1 in 4 patients with lupus develops symptoms of pericarditis
in their lifetime. There can be involvement of the heart musculature (myocarditis), heart valves causing leaky valves. Patients can have increased heart rate, chest pain, decreased exercise tolerance and shortness of breath. Patients with lupus are advised to be extra vigilant about these symptoms and receive medical care at a timely fashion. Investigations like laboratory tests, chest x ray,
