A study of cardiovascular manifestations in systematic lupus erythematosus in upper assam

Abstract

Background: Although cardiovascular disease (CVD) is recognized as a leading cause of death in patients with systemic lupus erythematosus (SLE) in Western countries, there are very few data available in Indian subjects with SLE.Aim: To determine the cardiovascular manifestations of SLE in Northeast region of Upper Assam.Method: Patients ruffling the 1997 updated American College of Rheumatology criteria for SLE cases had been studied between September 2010 and August 2011, who attended and were admitted in the Medicine, Dermatology, Cardiology, and Rheumatology Department of Assam Medical College, Dibrugarh, as this institution is a tertiary center of Upper Assam.Results: Seventy-three patients of SLE were evaluated over a period of 1 year. Patients with SLE presenting with multisystem involvement including cardiovascular system (CVS) had been studied. Cardiovascular manifestations in SLE are not uncommon in this part of the world. It is observed that cardiovascular manifestations develop in the majority of the SLE patients at any time during the course of their illness, the most common being pericardial effusion (PE) 16 (21.92%). Other manifestations were hypertension 8 (10.96%), valvular heart disease 5 (6.86%), pulmonary artery hypertension 4 (5.489/6), and 1 (1.37%) SLE patient had congestive heart failure. Among them 2 patients of SLE had valvular lesions associated with rheumatic heart disease (RHD). In the present study it is also observed that 2 (2.74%) patients of SLE had diastolic dysfunction, 1 (1.37%) patient had systolic dysfunction, and 1 (1.37%) patient had global hypokinesia. No case of endocarditis had been observed during the period of study.Conclusion: Systemic lupus erythematosus is a multisystem disorder affecting predominantly young females. Cardiovascular manifestations develop in the majority of SLE patients at any time during the course of their illness. The most common being the PE and even in echocardiography (ECHO) demonstrated an increased incidence of PE though the patients are having minimal symptoms. Chronic adhesive pericarditis, pericardial tamponade, and constrictive pericarditis occur rarely. So, it is thought that both clinical and laboratory investigations should be conducted to evaluate the cardiovascular manifestations in all SLE patients.