Lupus increases your risk for heart disease, including coronary artery disease (CAD). CAD happens when material builds up in the arteries and decreases blood flow to the heart. When blood flow to the heart is completely blocked, it causes a heart attack. Lupus can also cause inflammation in different parts of the heart:
- Endocarditis is inflammation in the heart walls and valves. It can cause clumps of material to build up on the heart valves, which may break off and form blood clots.
- Myocarditis is inflammation in the heart muscle. Symptoms can include chest pain, swelling, fatigue with exertion, or irregular heartbeat.
- Pericarditis is inflammation in the sac around the heart. Symptoms include chest pain and shortness of breath or pain with a deep breath.
Lupus and the blood
Lupus and lupus treatments can cause several problems with the blood and blood vessels, or the veins and arteries that carry blood to and from the heart. These include:
- High blood pressure (which increases risk for stroke, heart, and kidney disease)
- Anemia (not having enough red blood cells to carry oxygen through the body)
- Leukopenia (not having enough white blood cells to fight infections)
- Thrombocytopenia (not having enough platelets in the blood to help it clot)
Vasculitis
Lupus can also cause vasculitis, or inflammation in blood vessel walls that can block blood flow to your organs. Symptoms of vasculitis depend on which blood vessels are affected. These symptoms can include:
- Fever
- Weight loss
- Rash
- Blurry vision or new neurologic problems
Antiphospholipid antibody syndrome
Some people with lupus have antiphospholipid antibody syndrome (APS), a condition that increases the risk of thrombosis (blood clots inside blood vessels). These clots can cause serious complications, including:
- Stroke (blocked blood flow to the brain that causes brain cells to die)
- Heart attack (blocked blood flow to the heart that causes heart muscle to die)
- Pulmonary embolism (blocked blood flow to the lungs that causes lung tissue to die which can cause shortness of breath or pain with deep breaths)
If you’re pregnant, blood clots from APS can also cause miscarriage (loss of a pregnancy before 20 weeks). Ask your doctor about your risk for APS and whether you need a blood test. If you have APS, you may need medicine to help prevent clots.
Blood vessel problems that affect the skin
People with lupus can also have problems with blood vessels that you can see on the skin, including:
- Raynaud’s phenomenon (fingers and toes turning white or blue and feeling numb when a person is cold or stressed)
- Livedo reticularis (a blue or purple pattern showing through the skin that looks like lace or fishnet stockings)
- Palmar erythema (palms of the hands turning red)
Lupus and the lungs
One common lung problem in people with lupus is pleuritis, or inflammation of the tissue that covers the lungs. These inflamed lung surfaces can rub against each other when you breathe, causing chest pain. Pleuritis can also cause shortness of breath.
Lupus can also increase your risk for pneumonitis, or inflammation of the lung tissue. It’s usually caused by an infection. Symptoms include fever, cough, chest pain, and shortness of breath.
When pneumonitis lasts for a long time, it can cause interstitial lung disease — scarring of lung tissue that makes it hard to breathe.
A rare but serious lung problem is pulmonary hypertension, or high blood pressure in the blood vessels in the lungs. This condition is more common in people who have both lupus and another connective tissue disorder such as scleroderma.
Take steps to protect your heart
Heart disease is a leading cause of early death in people with lupus. The good news is there are lots of things you can do to help keep your heart healthy.
Try these steps:
- If you smoke, make a plan to quit
- Eat a healthy diet
- Get regular physical activity
- Keep your blood pressure and cholesterol under control
- Ask your doctor about taking aspirin every day
Certain lupus medicines, like steroids, can increase your risk for heart disease. Talk with your doctor about how your lupus medicines affect your risk for heart disease — and only take steroids if your doctor prescribes them as part of your lupus treatment.
Find out if you have heart problems
Often your primary doctor and lupus doctor can help manage your risk, and sometimes a cardiologist can find out if you have heart problems related to lupus. If you have symptoms of heart problems you may need different kinds of tests, including:
- Blood tests
- Chest X-rays
- Electrocardiogram (tests the electrical signals in your heart)
- Echocardiogram (uses sound waves to help the doctor see inside your heart)
Find the right treatment plan
Because lupus can cause a lot of different problems with the heart, lungs, and blood, there are many different treatment options. Your primary doctor, rheumatologist, or a cardiologist and pulmonologist can help you find a treatment plan that works for you.