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Lupus Myocarditis

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Updated February 10, 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. Lupus can trigger inflammation of the heart muscle (myocardium). When it does, the condition is called myocarditis, and occasionally lupus myocarditis.

Myocarditis:

Typically myocarditis is considered uncommon, and the result of any number of viral infections, though some bacterial and parasitic infections can lead to myocarditis. Adverse reactions to some medications might cause myocarditis, as well.

For lupus patients, myocarditis usually comes as a result of active lupus disease.

Myocarditis can be quite serious. Its effect on the heart –- inflamed and weakened muscle tissues –- can cause heart failure. The good news: Serious heart muscle disease is not common in SLE, according to the Lupus Foundation of America.

What the Doctor Will Look For:

One indicator your physician may notice prior to making a myocarditis diagnosis is inflammation of other muscle tissue.

Other symptoms or signs your doctor will look for include:

  • History of preceding viral illness
  • Fever
  • Chest pain
  • Joint pain or swelling
  • Abnormal heartbeat
  • Fatigue
  • Shortness of breath
  • Leg swelling
  • Inability to lie flat
  • Fainting, often related to arrhythmias
  • Low urine output

Autopsy studies have revealed that some people with SLE may have evidence of myocarditis in the tissues even in the absence of symptoms.

For those who have symptoms or signs that are suggestive of myocarditis, your doctor may conduct any number of tests, including an electrocardiogram, chest x-ray, echocardiogram, blood work and heart muscle biopsy.

Treating Myocarditis:

If it is determined that you do have myocarditis associated with SLE, your doctor may prescribe one of a number of treatment options. Those options may include medication and change in lifestyle (less activity) and diet (lower salt intake).

Medicines familiar with lupus patients might include corticosteroids and immunosuppressive drugs. Depending on the strength of the heart muscle, your doctor may prescribe further medication to treat the symptoms of heart failure.

Prognosis depends on the cause and the individual patient. While full recovery is possible for some, others may experience permanent heart failure. And, unfortunately, for some the condition can be fatal.

Sources:

Myocarditis. MedlinePlus Glossary. Updated July 2006.

Myocardium and Myocarditis. The American Heart Association. Collected January 2008.

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

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