Lupus and the Heart
Lupus impacts various organs and systems throughout the body, including the circulatory system. The more you understand about the impact of lupus on the body, the better equipped you are to make decisions that positively impact your long term health.
Understanding the heart and circulatory system
The circulatory system, including your heart and blood vessels, is responsible for carrying oxygen, hormones, and nutrients to the cells as well as removing waste products from the body. When the circulatory system doesn’t work the way it should, certain parts of the body can be deprived of oxygen, leading to shortness of breath, fatigue, tissue death, and other serious complications.
How lupus affects the heart and circulation
Lupus has a direct impact on the heart. In fact, heart disease is the leading cause of death among patients diagnosed with lupus. Close coordination with your provider can help you monitor and improve your heart health. Some of the most common heart complications associated with lupus include endocarditis, pericarditis, myocarditis, and coronary artery disease.
The lining inside your heart is called the endocardium. This material separates the chambers of the heart and lines the valves inside the heart.
The endocardium can also become inflamed as a direct result of the immune attack on healthy tissue caused by lupus. In the case of lupus-related endocarditis, lesions can develop on the surface of the heart valve, leading to bacterial endocarditis or blood clots that travel to the brain. These conditions can be life-threatening and require emergency medical attention.
Inside your chest cavity, a sac called the pericardium surrounds your heart. Because lupus leads to inflammation throughout the body, the pericardium can become inflamed, leading to chest pain and in some cases, shortness of breath. While pericarditis does not directly impact heart function, chronic inflammation in the pericardium can lead to scar tissue over time, causing more serious complications.
The muscle tissue that comprises your heart is called the myocardium. Patients with lupus who experience inflammation in muscles throughout their body are at high risk of also suffering from inflammation of the myocardium, called myocarditis. Symptoms of myocarditis include irregular heartbeat, rapid heartbeat, and chest pain.
Sometimes myocarditis occurs as a direct result of the immune response caused by lupus, but in other cases, it’s caused by viral, fungal, or bacterial infections. Patients with lupus are at higher risk of developing these infections because of the frequent use of immunosuppressive drugs in the treatment of this disease.
Untreated myocarditis can lead to heart failure, so close collaboration with your primary care provider and possibly a cardiologist will be critical for positive outcomes.
Coronary artery disease
Lupus in and of itself increases your risk of developing a condition called coronary artery disease, in which fats line the walls of your blood vessels, narrowing the passageway and restricting blood flow. This increased risk is the direct result of lupus but also other more complex factors related to a lupus diagnosis:
- High blood pressure, which can result from the use of corticosteroids or kidney disease
- Uncontrolled type 2 diabetes
- High Cholesterol related to the use of corticosteroids
- Lack of physical activity related to the pain, swelling, and joint problems caused by lupus
There are steps that you can take to reduce your risk of developing coronary artery disease and heart failure. Maintaining an active lifestyle within your limitations, keeping your blood pressure under control, choosing a healthy diet low in saturated fats, talking to your doctor about the risks and benefits of cortical steroids, and keeping your lupus under control to the extent possible by working directly with a provider on a routine basis can help.
Vasculitis, or inflammation of the blood vessel itself, can be very serious. Symptoms of vasculitis include fever, malaise, blurry vision, headache, and weight loss. You might also experience behavioral changes – such as aggression – or more serious symptoms like stroke or seizure. If you think you may be suffering from vasculitis, seek emergency medical attention.
Overall, lupus can have devastating effects on the heart if not adequately managed but there are steps you can take to reduce your risk and prevent heart disease. Your doctor can assist through routine monitoring for early detection of heart problems.