Cardiopulmonary Disease
Coronary artery disease
The coronary arteries deliver blood and oxygen to the heart muscle and are vital to the heart's pumping function. In people with lupus, these arteries can become prematurely narrowed, causing coronary artery disease.
Studies suggest that people with lupus are more likely to develop premature atherosclerosis if they are on corticosteroids (prednisone) or have kidney involvement.
This blockage can be due to:
- inflammation of the artery wall (arteritis)
- cholesterol deposits inside the wall (atherosclerosis)
- arterial spasm
- blood clot (thrombus)
Symptoms of coronary artery disease
- Narrowing or blockage of an artery can lead to chest pain and a heart attack.
- Atherosclerosis is the most common cause of coronary artery disease in lupus.
In addition, heart damage can develop from inflammation in active lupus or from medications.
Diagnosing coronary artery disease
Early and accurate diagnosis, combined with aggressive therapy to reduce organ damage, is crucial in order to minimize permanent heart damage. Typical tests include:
- chest x-ray
- electrocardiogram
- echocardiogram
- blood tests to evaluate lupus activity.
Treating coronary artery disease
Treatment of cardiac problems must be individualized for each person and for each problem. However, prevention is the primary treatment of coronary artery disease.
These are three important factors in preventing heart attacks in people with lupus:
- Controlling cardiac risk factors
- Controlling lupus disease activity
- Carefully monitoring corticosteroid use.
Pulmonary (Lung) Involvement
The wide range of pulmonary manifestations (symptoms) associated with lupus needs prompt evaluation and close monitoring.
Diagnostic tools can include:
- chest x-ray
- ventilation-perfusion scan of the lung
- gallium scan
- high-resolution CT scan
- bronchoalveolar lavage
- pulmonary function tests.