Heart and Lung Involvement
Lupus is an autoimmune disease that can affect almost any part
of your body, most often your joints, skin, kidneys, heart, lungs, blood, or
brain.
Your heart, blood vessels, and lungs make up your
cardiovascular/pulmonary network: "cardio" refers to the heart, "vascular"
refers to the arteries, veins, and capillaries, and “pulmonary” refers to the
lungs. Your blood circulates through this vast system, transporting oxygen and
other elements needed for your cells and tissues to function properly.
Cardiologists are the physicians who specialize in the heart. Pulmonologists
are the physicians who specialize in the lungs.
The Heart
Heart disease is a major complication of lupus and is now a
leading cause of death among people with lupus. Blood tests, chest X-rays, an
electrocardiogram (EKG), or an echocardiogram may be used to find out if you
have a heart condition caused by lupus.
Pericarditis
The most common way that lupus affects the heart is through
inflammation of the pericardium, the sac that surrounds your heart. The
symptoms of pericarditis that you may experience are sharp pain in your chest
and, occasionally, shortness of breath. Pericar-ditis usually does not damage
your heart’s ability to function because it does not directly involve the heart
tissue. However, inflammation that is chronic (long-lasting) can scar the heart
tissue, which can interfere with the heart’s ability to pump blood.
Myocarditis
Lupus can cause inflammation of the myocardium, the muscle
tissue of your heart. The symptoms are chest pain and an unexplained rapid or
irregular heart beat. Myocarditis is often seen when there is inflammation in
other muscles in the body.
However, myocarditis can be caused by viral, bacterial, and
fungal infections. Because lupus itself creates an added risk for developing
infections -- especially if you are taking certain immunosuppressive drugs --
you are at increased risk for this type of myocarditis.
Though serious heart muscle disease is not commonly caused by
lupus, heart failure can occur if your heart does not have the strength to pump
enough blood to the different tissues and organs.
Endocarditis
The endocardium is the tissue that lines the inner walls of
your heart and the valves that separate the heart’s different chambers. Lupus
can cause inflammation of the endocardium. Lupus endocarditis usually causes
the surfaces of the heart valve to thicken or develop wart-like growths
(lesions). These lesions can become infected, a condition called bacterial
endocarditis. A lesion also could break off and travel to the brain to form a
blood clot. Both of these possibilities are potentially very
dangerous.
Coronary Artery Disease
The coronary arteries move blood to and from your heart. Over
time, fatty molecules and other materials may attach to the walls of these
blood vessels and form plaque, which makes the blood vessels narrower and
restricts blood flow. This condition is known as atherosclerosis. A decrease in
blood flow can cause angina (chest pain). However, if the blood flow to your
heart is interrupted -- either by plaque or by a blood clot that develops when
plaque breaks off -- you could be at risk for a heart attack.
When you have lupus you are at increased risk for coronary
artery disease. This is partly because people with lupus have more risk
factors, which may include:
people with lupus are more likely to develop atherosclerosis. You can help
reduce your chances of heart attacks and other complications from coronary
artery disease in several ways:
Blood is made up of many different parts, but those that are
most often affected by lupus are the red blood cells, the white blood cells,
and the platelets.
Anemia
Anemia occurs when not enough oxygen is transported to the
tissues in your body. There are several possible causes for this:
is not producing enough red blood cells. However, sometimes antibodies target
healthy red blood cells for destruction. This condition is called hemolytic
anemia, or simply hemolysis. Hemolysis can cause a yellowish color in your skin
and eyes and is a serious condition.
Anemia may also be caused by aspirin, ibuprofen, and other
non-steroidal anti-inflammatory drugs (NSAIDs) used to treat lupus. These drugs
can irritate the lining of your stomach, which may lead to bleeding and loss of
red blood cells. Feeling very tired is the earliest and most common symptom of
anemia.
Leukopenia and Neutropenia
If you have too few white blood cells in your body you may
develop leukopenia and/or neutropenia (also called granulocytopenia). Both are
common in people with active lupus. Low numbers of white blood cells may be due
to an infection in your body, or due to certain drugs used to control lupus
that work by suppressing your immune system.
Thrombocytopenia
If you have low platelet numbers you may develop
thrombocytopenia. This condition is almost always caused by antibodies that
attack and destroy healthy platelets. The symptoms of a low platelet count are
bruising, nosebleeds, or the appearance of tiny red bleeding points in your
skin (especially on your lower legs) called petechiae (pronounced
pah-TEE-kee-eye). Although thrombocytopenia is common in lupus, serious
bleeding usually does not occur.
Thrombosis
The blood’s ability to form clots at the site of wounds is
absolutely essential. Sometimes, unnecessary clots form inside the blood
vessels and prevent the blood from circulating, a condition called thrombosis.
If a thrombus, or blood clot, breaks off and travels through your blood, it is
called an embolus or embolism.
Thrombosis is a serious and frequent complication of lupus. A
clot in the veins of the lower leg can make walking painful and difficult, and
may also produce an embolism that travels up into another part of your body. A
clot in the lungs can cause high blood pressure (hypertension). A clot in a
blood vessel of the brain can cause a stroke. During pregnancy, blood clots can
lodge in the placenta and disrupt nutrition to the fetus.
Most blood clots in lupus are associated with antibodies in
the blood to substances called phospholipids. People with lupus who have
antiphospholipid antibodies are much more likely to have blood clotting
problems.
The Circulatory System
Inflammation in a small blood vessel like a capillary may
cause that vessel to break and bleed inside the tissue. Inflammation that
occurs in the skin may appear as a small red or purple dot. Inflammation that
takes place in other tissues can be extremely serious, especially within the
brain. Vasculitis is caused by inflammation of the blood vessel walls. The
symptoms of lupus-induced vasculitis that you may experience can vary depending
upon which tissues are involved, but may include:
Inflammation caused by lupus may affect the lungs in many
ways, and can involve the membrane lining of the lungs, the lungs themselves,
the blood vessels within the lungs, and the diaphragm.
Pleuritis
The most common way that lupus can affect your lungs is
through inflammation of the pleura, the lining that covers the outside of the
lungs. The symptom of pleuritis that you may experience is severe, often sharp,
stabbing pain in a specific area or areas of your chest. The pain, which is
called pleurisy, is made worse when you take a deep breath, cough, sneeze, or
laugh. You may also experience shortness of breath. Sometimes an abnormal
amount of fluid will build up in the space between your lungs and your chest
wall; when it leaks out it is called a pleural effusion. Pain from pleurisy,
with or without effusions, is found in 40 to 60 percent of people with
lupus.
Pneumonitis
The term for inflammation within the lung tissue is
pneumonitis. The symptoms of pneumonitis that you may experience are fever,
chest pain, shortness of breath, and cough. An infection caused by bacteria,
virus, or fungi is the most common cause of pneumonitis.
Chronic Diffuse Interstitial Lung Disease
When inflammation in the lungs is chronic, it can cause
scarring. This scar tissue can prevent oxygen from moving easily from your
lungs into your blood and may cause diffuse (widespread) interstitial lung
disease. The symptoms that you may experience include a chronic dry cough,
chest pain, and difficulty breathing during physical activity.
Pulmonary Emboli
Blood clots that block the arteries leading to the lungs are
called pulmonary emboli. These blood clots will cause chest pain and shortness
of breath, but can also lead to a decrease in oxygen flow in your lungs. You
are at increased risk for pulmonary emboli if you have antiphospholipid
antibodies, vascular damage, and/or an inactive lifestyle.
This information comes from the Lupus Foundation of America and here
of your body, most often your joints, skin, kidneys, heart, lungs, blood, or
brain.
Your heart, blood vessels, and lungs make up your
cardiovascular/pulmonary network: "cardio" refers to the heart, "vascular"
refers to the arteries, veins, and capillaries, and “pulmonary” refers to the
lungs. Your blood circulates through this vast system, transporting oxygen and
other elements needed for your cells and tissues to function properly.
Cardiologists are the physicians who specialize in the heart. Pulmonologists
are the physicians who specialize in the lungs.
The Heart
Heart disease is a major complication of lupus and is now a
leading cause of death among people with lupus. Blood tests, chest X-rays, an
electrocardiogram (EKG), or an echocardiogram may be used to find out if you
have a heart condition caused by lupus.
Pericarditis
The most common way that lupus affects the heart is through
inflammation of the pericardium, the sac that surrounds your heart. The
symptoms of pericarditis that you may experience are sharp pain in your chest
and, occasionally, shortness of breath. Pericar-ditis usually does not damage
your heart’s ability to function because it does not directly involve the heart
tissue. However, inflammation that is chronic (long-lasting) can scar the heart
tissue, which can interfere with the heart’s ability to pump blood.
Myocarditis
Lupus can cause inflammation of the myocardium, the muscle
tissue of your heart. The symptoms are chest pain and an unexplained rapid or
irregular heart beat. Myocarditis is often seen when there is inflammation in
other muscles in the body.
However, myocarditis can be caused by viral, bacterial, and
fungal infections. Because lupus itself creates an added risk for developing
infections -- especially if you are taking certain immunosuppressive drugs --
you are at increased risk for this type of myocarditis.
Though serious heart muscle disease is not commonly caused by
lupus, heart failure can occur if your heart does not have the strength to pump
enough blood to the different tissues and organs.
Endocarditis
The endocardium is the tissue that lines the inner walls of
your heart and the valves that separate the heart’s different chambers. Lupus
can cause inflammation of the endocardium. Lupus endocarditis usually causes
the surfaces of the heart valve to thicken or develop wart-like growths
(lesions). These lesions can become infected, a condition called bacterial
endocarditis. A lesion also could break off and travel to the brain to form a
blood clot. Both of these possibilities are potentially very
dangerous.
Coronary Artery Disease
The coronary arteries move blood to and from your heart. Over
time, fatty molecules and other materials may attach to the walls of these
blood vessels and form plaque, which makes the blood vessels narrower and
restricts blood flow. This condition is known as atherosclerosis. A decrease in
blood flow can cause angina (chest pain). However, if the blood flow to your
heart is interrupted -- either by plaque or by a blood clot that develops when
plaque breaks off -- you could be at risk for a heart attack.
When you have lupus you are at increased risk for coronary
artery disease. This is partly because people with lupus have more risk
factors, which may include:
- hypertension from kidney disease or corticosteroid use
- elevated cholesterol levels from corticosteroid use
- type 2 diabetes from corticosteroid use
- an inactive, sedentary lifestyle due to fatigue, joint problems, and/or
muscle pain
people with lupus are more likely to develop atherosclerosis. You can help
reduce your chances of heart attacks and other complications from coronary
artery disease in several ways:
- control the risk factors
- control the lupus disease activity
- talk to your doctor about reducing or stopping your corticosteroid
use
Blood is made up of many different parts, but those that are
most often affected by lupus are the red blood cells, the white blood cells,
and the platelets.
Anemia
Anemia occurs when not enough oxygen is transported to the
tissues in your body. There are several possible causes for this:
- too few red blood cells
- not enough hemoglobin
- not enough blood circulating in the body
is not producing enough red blood cells. However, sometimes antibodies target
healthy red blood cells for destruction. This condition is called hemolytic
anemia, or simply hemolysis. Hemolysis can cause a yellowish color in your skin
and eyes and is a serious condition.
Anemia may also be caused by aspirin, ibuprofen, and other
non-steroidal anti-inflammatory drugs (NSAIDs) used to treat lupus. These drugs
can irritate the lining of your stomach, which may lead to bleeding and loss of
red blood cells. Feeling very tired is the earliest and most common symptom of
anemia.
Leukopenia and Neutropenia
If you have too few white blood cells in your body you may
develop leukopenia and/or neutropenia (also called granulocytopenia). Both are
common in people with active lupus. Low numbers of white blood cells may be due
to an infection in your body, or due to certain drugs used to control lupus
that work by suppressing your immune system.
Thrombocytopenia
If you have low platelet numbers you may develop
thrombocytopenia. This condition is almost always caused by antibodies that
attack and destroy healthy platelets. The symptoms of a low platelet count are
bruising, nosebleeds, or the appearance of tiny red bleeding points in your
skin (especially on your lower legs) called petechiae (pronounced
pah-TEE-kee-eye). Although thrombocytopenia is common in lupus, serious
bleeding usually does not occur.
Thrombosis
The blood’s ability to form clots at the site of wounds is
absolutely essential. Sometimes, unnecessary clots form inside the blood
vessels and prevent the blood from circulating, a condition called thrombosis.
If a thrombus, or blood clot, breaks off and travels through your blood, it is
called an embolus or embolism.
Thrombosis is a serious and frequent complication of lupus. A
clot in the veins of the lower leg can make walking painful and difficult, and
may also produce an embolism that travels up into another part of your body. A
clot in the lungs can cause high blood pressure (hypertension). A clot in a
blood vessel of the brain can cause a stroke. During pregnancy, blood clots can
lodge in the placenta and disrupt nutrition to the fetus.
Most blood clots in lupus are associated with antibodies in
the blood to substances called phospholipids. People with lupus who have
antiphospholipid antibodies are much more likely to have blood clotting
problems.
The Circulatory System
Inflammation in a small blood vessel like a capillary may
cause that vessel to break and bleed inside the tissue. Inflammation that
occurs in the skin may appear as a small red or purple dot. Inflammation that
takes place in other tissues can be extremely serious, especially within the
brain. Vasculitis is caused by inflammation of the blood vessel walls. The
symptoms of lupus-induced vasculitis that you may experience can vary depending
upon which tissues are involved, but may include:
- fever
- feeling ill
- poor appetite
- weight loss
- headache
- blurry vision
- seizures
- strokes
- behavioral disturbances
Inflammation caused by lupus may affect the lungs in many
ways, and can involve the membrane lining of the lungs, the lungs themselves,
the blood vessels within the lungs, and the diaphragm.
Pleuritis
The most common way that lupus can affect your lungs is
through inflammation of the pleura, the lining that covers the outside of the
lungs. The symptom of pleuritis that you may experience is severe, often sharp,
stabbing pain in a specific area or areas of your chest. The pain, which is
called pleurisy, is made worse when you take a deep breath, cough, sneeze, or
laugh. You may also experience shortness of breath. Sometimes an abnormal
amount of fluid will build up in the space between your lungs and your chest
wall; when it leaks out it is called a pleural effusion. Pain from pleurisy,
with or without effusions, is found in 40 to 60 percent of people with
lupus.
Pneumonitis
The term for inflammation within the lung tissue is
pneumonitis. The symptoms of pneumonitis that you may experience are fever,
chest pain, shortness of breath, and cough. An infection caused by bacteria,
virus, or fungi is the most common cause of pneumonitis.
Chronic Diffuse Interstitial Lung Disease
When inflammation in the lungs is chronic, it can cause
scarring. This scar tissue can prevent oxygen from moving easily from your
lungs into your blood and may cause diffuse (widespread) interstitial lung
disease. The symptoms that you may experience include a chronic dry cough,
chest pain, and difficulty breathing during physical activity.
Pulmonary Emboli
Blood clots that block the arteries leading to the lungs are
called pulmonary emboli. These blood clots will cause chest pain and shortness
of breath, but can also lead to a decrease in oxygen flow in your lungs. You
are at increased risk for pulmonary emboli if you have antiphospholipid
antibodies, vascular damage, and/or an inactive lifestyle.
This information comes from the Lupus Foundation of America and here