Cardiovascular Complications in Systemic Lupus Erythematosus

Abstract

Systemic lupus erythematosus (SLE) is an auto-immune disease of a relapsing-remitting nature that can cause multiorgan damage depending on several factors, mainly the disease activity. Young age women are the most likely to be affected by the disease and the female-to-male prevalence ratio is approximately 1:10. As the number of SLE patients has been increasing in the last few decades, the annual number of deaths due to the disease and its complications has increased as well, and one of the most important systems to which high mortality is attributed is the cardiovascular system, leading to premature atherosclerosis and other events such as endocarditis and valve disease. In addition to the classical cardiovascular risk factors, studies have found a positive correlation between SLE and other cardio-harmful diseases such as metabolic syndrome and dyslipidemia. Moreover, some of the medications used in the treatment of SLE place a heavy burden on the heart. The article reviews the shared pathophysiology of SLE and cardiovascular disease along with the most common SLE-associated cardiac risks, events, and management.

Cardiac Tamponade, an Unusual First Presentation of Systemic Lupus Erythematosus: A Case Report in a Rural Tertiary Hospital

“…Approximately half of SLE patients will experience cardiac complications [3,4]. Pericarditis, myocarditis, valve disorders, thrombosis, and conduction system abnormalities are among the most prevalent cardiac complications in SLE patients [2]. The most prevalent cardiac manifestation of SLE is pericarditis, which has been linked to poor survival.…”

“…About 25% of all SLE patients develop symptomatic pericarditis at some point throughout the disease, most commonly in conjunction with concomitant pleuritis [7]. Nonetheless, autopsy investigations indicate a higher incidence of subclinical pericarditis [2,8]. Imaging examinations revealed that more than 30% of patients were found to have pericardial involvement [9].…”

“…It is characterized by the formation of immune complexes and autoantibodies and can affect any organ system [1]. The disease is more prevalent among younger women, with a female-tomale prevalence ratio of approximately 10:1 [2]. Cardiac involvement is common and can be found in more than half of SLE patients [3,4].…”

Cardiac tamponade in a male as an initial presentation of SLE. An interesting case report

“…Hypotension, pulsus paradoxus, dyspnea, orthopnea, and chest discomfort are typical symptoms and indicators (Figure 1). SLE may be difficult to diagnose, and there is no one clinical symptom or laboratory abnormalities that can definitively rule out the disease [5]. SLE is instead identified based on a combination of symptoms, signs, and relevant laboratory tests.…”

Inflammasomes as potential mediators of adverse cardiovascular events in diabetes and lupus: more questions than answers

“…However, unlike T2DM, SLE patients are at an even greater risk of adverse clinical events, as these patients not only might be affected by traditional (Framingham) CVD risk factors, but also afflicted by SLE-disease-specific elements 6 . These SLE-specific risk elements increase the risk of CAD by up to 10 times when compared with the general population and these manifestations are mainly seen among young SLE patients 7,8 …”