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Related Conditions: Lupus Pericarditis

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Updated January 30, 2008

Systemic lupus erythematosus (SLE), an autoimmune disease, is truly a disease of symptoms. Its attacks on the body’s immune system can affect everything from the skin and joints to internal organs.

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:

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.

What the Doctor Will Look For:

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 doctor 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.

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:

  • Medical history and physical exam.
  • Electrocardiogram
  • Chest X-ray
  • Echocardiogram
  • CT-Scan (computerized tomography)
  • Magnetic resonance imaging.

Treating Pericarditis:

For lupus patients, pericardits is typically treated with anti-inflammatory drugs. Failing that, 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. This is pretty rare 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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