A Look at Lupus Pericarditis

Examining the Symptoms and Treatment of Lupus Pericarditis

The pericardium is a sac surrounding the heart.
The pericardium is a sac surrounding the heart.. Science Photo Library - PIXOLOGICSTUDIO/Getty Images

Systemic lupus erythematosus (SLE) or "lupus," is truly an autoimmune disease of symptoms. Its attacks on the body’s immune system can affect everything from the skin and joints to internal organs. Furthermore, SLE can also attack the heart and result in pericarditis.

Complications from SLE affecting the heart are common in lupus patients. Often, lupus can trigger inflammation of the thin sac surrounding the heart (pericardium).

When it does, the condition is called pericarditis, and occasionally lupus pericarditis.

Pericarditis in People with Lupus

Lupus patients tend to develop pericarditis more than any other disease of the heart. The trigger, it seems, is antigen-antibody complexes produced during active lupus.

This condition occurs when antigen-antibody complexes--also known as immune complexes--are made during active lupus and cause inflammation within the pericardium.

While mild cases of pericarditis often improve on their own, often in less than a month, the situation is a bit different for lupus patients, as is the healing time. Often pericarditis will hang around a while longer.

Diagnosing Lupus Pericarditis

For those who have not yet be diagnosed with lupus, pericarditis could be seen as an indicator, and a path toward diagnosis a doctor may take – especially since the cause of pericarditis is often hard to determine.

The most common symptom of pericarditis is sharp, stabbing chest pain right behind the breastbone or on the left side of your chest. Pain often intensifies when lying flat or inhaling deeply. Sitting up and leaning forward often ease the pain.

Other signs and symptoms your physician will look for include:

  • Shortness of breath
  • Low-grade fever
  • Fatigue or feeling sick
  • Dry cough
  • Abdominal or leg swelling

Beyond lupus, pericarditis can also be caused as a residual effect of heart attack, trauma, health disorders like kidney failure, and, in rare instances, certain medications.

Diagnostic Tests for Lupus

In addition to the medical history and physical exam, to determine the cause of your pericarditis, and to either underscore or rule out lupus as the culprit, your physician will conduct tests, including any number of those listed below:

  • Electrocardiogram
  • Chest X-ray
  • Echocardiogram
  • CT Scan (computerized tomography)
  • Magnetic resonance imaging.

Treating Pericarditis in People with Lupus

For people with lupus, pericarditis is typically treated with anti-inflammatory drugs. If these drugs fail to help, a brief course of corticosteroid treatment is usually needed.

In people who also have large or loculated pericardial effusions in association with the pericarditis, pericardial drainage may be necessary. Drainage is rarely done and only necessary when the fluid is resulting in impaired cardiac function.

Sources:

Pericarditis. Mayo Foundation for Medical Education and Research. Mayo Clinic Staff. May 2007.

Pericarditis. JAMA Patient Page. Journal of the American Medical Association. Sharon Parmet, MS. March 2003.

Cardiopulmonary Disease. Lupus Foundation of America. Collected January 2008.

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