Systemic Lupus Erythematosus: Review of Cardiovascular Aspects

Myocarditis with Cardiogenic Shock as the First Manifestation of Systemic Lupus Erythematosus

“…SLE is a chronic inflammatory multisystemic autoimmune disease with complex characteristics that affects mainly women, of which onset usually occurs between the ages of 16 and 55 years-old; it has a variable frequency in the general population, with an incidence of 1:200 in black women. 1 …”

“…To diagnose SLE according to the new recommendations, four or more criteria must be met, and at least one must be clinical, whereas one must be immunological. 1 …”

“…Although cardiovascular impairment is very common in patients with SLE, with a prevalence of up to 40-50% in postmortem studies, it is not part of the new diagnostic criteria; it is considered only associated damage due to long-term disease. 1 - 5 It may manifest as pericarditis, myocarditis, Libman-Sacks endocarditis, pulmonary arterial hypertension or coronary artery disease; coronary artery disease is the most prevalent one, due to the inflammatory process of the disease itself together with the use of corticosteroids, which are commonly employed in the treatment of lupus. 6…”

“…Even though the kidneys are classically considered the main organ affected by SLE, cardiomyopathy is one of the complications more frequently associated with morbidity and mortality in SLE patients. 1 Cardiovascular impairment can be highly variable in terms of the affected structures and, in severe cases, may lead to cardiogenic shock.…”

Systematic Lupus Erythematosus (SLE): A review on the prevalence, clinical manifestation, and disease assessment

“…Studies have reported that arthrosclerosis increases the risk of cardiovascular events amongst SLE patients. Systolic murmurs are also commonly found sign, affecting 30% of SLE patients, whereas diastolic murmurs are less common [52,53] .…”