A STUDY ON CARDIOVASCULAR MANIFESTATIONS OF SYSTEMIC LUPUS ERYTHEMATOSUS.

Corresponding Author:
Dr. Vijay Narayanan Harikumar,
Prashanth, NRA-27, Navarangam Lane,
Medical College P.O. Trivandrum-11, Kerala.
E-mail: vijaynh@gmail.com

ABSTRACT

BACKGROUND

SLE is a classic prototype for a multisystem inflammatory disease with autoimmune aetiology. Because of the pleomorphic nature of this disease, its cardiovascular manifestations have not always been emphasised. This study aims to look at prevalence of cardiovascular manifestations in SLE.

Objective- To study the prevalence of cardiovascular manifestations in large living group of unselected patients with SLE both clinically and investigation wise including two dimensional and Doppler echocardiography and analysing their relation with clinical features of cardiovascular involvement.

MATERIALS AND METHODS

100 patients diagnosed to have SLE (Based on 2012 SLICC criteria) attending Rheumatology OPD and inpatients in General Medicine ward formed the study group. This group of patients were studied for 12 months. The study design was that of an observational study. Data was collected using pretested structured proforma. Data analysis was done using SPSS software.

RESULTS

Mean age at diagnosis of SLE was 34.5 years. Female to male ratio was 11.5:1. The most common cardiac symptom was dyspnoea on exertion (23%). Other prominent symptoms included palpitation (11%), chest pain (8%), cough (7%), syncope (3%). Mean pulse rate was 76.7, mean systolic and diastolic blood pressures were 118.1 and 74.1 respectively. JVP was elevated in 2% of patients. Apex beat was displaced in 11% of patients. Pericardial rub was audible in 3% of patients, S4 in 2% and S3 in 1%. 8% of patients had an audible murmur, 7% had pansystolic murmur of mitral regurgitation, 1% had both MR and AR murmur. Pericardial effusion was present in 17% of patients, 13% had mild pericardial effusion whereas 4% had moderate pericardial effusion. Cardiac tamponade was not seen in any patient. Myocarditis was not seen in any patient. Left ventricular systolic dysfunction was seen in 7% whereas diastolic dysfunction was more common with a prevalence of 10%. Mitral regurgitation was the most common valvular lesion identified, with a prevalence of 10%. The prevalence of aortic regurgitation was 3. Pulmonary hypertension was found with a prevalence of 6%. Libman-Sacks endocarditis was not observed.

CONCLUSION

Prevalence of cardiovascular manifestation in SLE in our study was 37%, the most common manifestations being Pericarditis and Pericardial effusion-17%. The most common valvular lesion identified was Mitral Regurgitation (10%). A high index of clinical suspicion is needed to pick up cardiac lesions in SLE. Though many of these patients are asymptomatic, early intervention can be beneficial.

KEYWORDS

SLE, Pericarditis, Pericardial Effusion, Mitral Regurgitation.