Lupus and pericarditis: Effect of lupus on heart health

Lupus can contribute to pericarditis – inflammation of the pericardium, a part of the heart. Lupus is an autoimmune disease that can affect many areas of the body, including skin, joints and kidneys. Lupus can also affect the heart in numerous ways as the heart consists of many tissues that can become inflamed and scar. Arteries leading to the heart can narrow, causing damage and disrupting blood flow.

Pericarditis is a common heart complication as a result of lupus. The pericardium is a protective cushion that surrounds the heart and cushions the chest. Lupus can cause the pericardium to become inflamed, which can lead to chest pains. This pain can become worsened with deep breaths and through the changing of bodily positions. Although the condition is not life threatening, it can be quite painful, and when a lupus patient develops it medical attention should be sought out to ensure a heart attack is not taking place.

Lupus, pericarditis and other heart conditions

Lupus is a condition categorized by tissue inflammation. As an autoimmune disease the body’s immune system begins to attack its own tissue thus contributing to inflammation.

Although anyone can develop pericarditis, it is quite common in those with lupus so it is sometimes referred to as lupus pericarditis. Rates of pericarditis are generally higher in those with lupus than the general public.

Aside from pericarditis, lupus can affect the heart in other ways, including the following conditions:

• Vascular disorders – valves within the heart can become inflamed due to lupus. Inflammation of the valves is symptomless but if scarring occurs, it can lead to damage.
• Myocarditis – this is inflammation of the heart muscle. Chest pain and shortness of breath are symptoms of myocarditis. If permanent damage occurs, it can lead to congestive heart failure.
• Arrhythmia – this is an irregular heartbeat. Tissues that control electrical pulses become inflamed causing the heart to beat irregularly.
• Coronary artery disease – CAD is hardening of the arteries and is the number one killer in North America. Those with lupus are at higher risk for CAD and can be accompanied by chest pains, shortness of breathe, profuse sweating, nausea, vomiting, diarrhea and weakness.

Symptoms of lupus pericarditis

Symptoms of lupus pericarditis include:

• Sharp, stabbing chest pain behind the breastbone on the left side of the chest
• Pain that worsens when lying down
• Pain that improves when sitting up or leaning forward
• Shortness of breathe
• Low-grade fever
• Fatigue or feeling of sickness
• Dry cough
• Abdominal or leg swelling

Diagnosis and treatment of pericarditis in lupus

Diagnosis of pericarditis involves the use of different tests to get a proper diagnosis. Medical tests that your doctor may request are:

• Medical history and physical exam
• Electrocardiogram
• Chest x-ray
• CT scan
• Magnetic resonance imaging (MRI)

The main form of treatment for lupus patients with pericarditis involves the use of anti-inflammatory medication. If this treatment is not effective, corticosteroids may be used instead for a shorter duration.

Treatment is generally short and discontinued when the patient is feeling better. This is to ensure minimal side effects and complications by the corticosteroids. In patients with large or loculated pericardial effusions, pericardial drainage may be performed as well. This form of treatment is rare and is only necessary if function of the heart needs to be restored.

Lifestyle habits, too, have been shown to improve lupus pericarditis. A combination of healthy eating and physical activity can help reduce the recurrence of symptoms.

Lupus complications

Complications associated with lupus include:

• Kidney failure
• Blood problems
• High blood pressure
• Inflammation of blood vessels
• Memory problems
• Behavior changes or hallucinations
• Seizures
• Stroke
• Heart disease or heart attack
• Lung conditions
• Infections
• Cancer
• Death of bone tissue

In order to minimize the risk of complications, speak to your doctor about treatment options and consider alternative remedies, such as acupuncture, massage, yoga, meditation, chiropractic treatment and dietary supplements to help improve the outcome of lupus.