The countdown of my top five blog posts in 2017 continues with number 2: Lupus and the Heart.
Most of know by now that heart disease can be linked with a diet high in processed foods, sugars and refined carbohydrates, lack of activity, and obesity. This is good news! With proper diet and exercise those who make the effort can make this bad situation better or reverse their condition.
When an autoimmune reaction is part of the heart disease picture, the approach is more complicated. If the autoimmunity has destroyed enough tissue, it can be too late to reverse the condition and its symptoms. More and more people are being diagnosed with autoimmune disorders, so it is to be hoped that more doctors will screen for autoimmunity so an autoimmune heart condition can be caught in time to manage it.
What is heart autoimmunity?
The symptoms of an autoimmune reaction against the heart mimic heart disease symptoms. They include:
- cardiomegaly (enlarged heart)
- fluid retention
- tiring easily
- chest pain
- edema with exercise
- and difficulty breathing.
An unmanaged autoimmune reaction to the heart can cause inflammation, scarring, and, in rare cases, sudden death. Also, poor heart function affects the lungs, liver, and other organs and systems in the body.
Did you know that doctors in the standard health care model do not screen for autoimmunity until the end stages of disease when symptoms are severe. Fortunately, you can identify an autoimmune reaction before it’s too late with a blood serum antibody panel.
What is a blood serum antibody panel?
This panel screens for autoimmunity against heart tissue by checking for myocardial (a protein the heart releases in response to stress) or alpha-myosin (cardiac tissue) antibodies. If these come back positive it’s an indication the immune system is attacking heart tissue. If the condition is more advanced, you may be given a diagnosis of cardiomyopathy, or disease of the heart muscle.
Be in control. If you know you have an autoimmune condition, share this with your doctor right away. You can take the steps to potentially slow or halt its progression through proven diet, lifestyle, and nutritional therapy strategies. You should also regularly monitor your heart health.
Lupus can cause inflammation of the myocardium, the muscle tissue of your heart. The symptoms are:
- chest pain
- an unexplained rapid or irregular heart beat
- shortness of breath
Myocarditis is often seen when there is inflammation in other muscles in the body.
Myocarditis is usually caused by a viral infection. A severe case can weaken the heart, which can lead to heart failure, abnormal heartbeat, and sudden death.Symptoms include chest pain, abnormal heartbeat, and shortness of breath.Treatment may include medication to regulate the heartbeat and improve heart function. In rare but severe cases, a device may be needed to help the heart function.
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.
Immunosuppressive drugs or immunosuppressive agents or antirejection medications are drugs that inhibit or prevent activity of the immune system.
Though serious heart muscle disease is not commonly caused by lupus, heart failure can occur if our heart does not have the strength to pump enough blood to the different tissues and organs.
- sharp pain in your chest
- occasionally, shortness of breath.
Pericarditis usually does not damage our 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.
Pericarditis may be caused by a viral infection or heart attack. In many cases, the cause is unknown.The most common symptom is sharp, stabbing chest pain that may travel to the left shoulder and neck. Pericarditis usually begins suddenly but doesn’t last long.Most cases are mild and usually improve on their own. Treatment for more severe cases may include medications and, rarely, surgery.
The endocardium is the tissue that lines the inner walls of our 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 usual cause is the buildup of plaque. This causes coronary arteries to narrow, limiting blood flow to the heart.Coronary artery disease can range from no symptoms, to chest pain, to a heart attack.Treatments include lifestyle changes, medications, angioplasty, and surgery.
- 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
However, even after taking these risk factors into account, those of us with lupus are more likely to develop atherosclerosis. We can help reduce our chances of heart attacks and other complications from coronary artery disease in several ways:
- Control the risk factors
- Control the lupus disease activity
- Talking with our doctor about reducing or stopping corticosteroid use
A build up of cholesterol plaque in the walls of arteries causing obstruction of blood flow. Plaques may rupture causing acute occlusion of the artery by clot.Atherosclerosis often has no symptoms until a plaque ruptures or the buildup is severe enough to block blood flow.A healthy diet and exercise can help. Treatments include medications, procedures to open blocked arteries and surgery.