Heart and Lungs
People with lupus are at a higher risk for cardiovascular and pulmonary disorders. Coronary disease alone accounts for one-third of all SLE related deaths. Pulmonary hemorrhage only occurs in 1 percent of lupus patients but accounts for 10 percent of lupus deaths.
The effect lupus has on the heart and lungs is very serious, and special attention need to be placed in identifying lupus-related issues surrounding these two systems.
There are several lupus-related disorders that affect the lungs. The most common problem is pleurisy, but others include ALP, ILD, pulmonary embolism, and pulmonary hemorrhage.
Simply put, pleurisy is pain in the chest upon taking a deep breath. The pleura is the thin membrane around the lung. When it is inflamed it is called pleuritis, and when fluid leaks from the pleura the patient suffers from a pleural effusion.
Pleurisy is found in 40 to 60 percent of SLE patients, and on autopsy 50 percent of SLE patients show pleural abnormalities.
Acute Lupus Pneumonitis (ALP)
Characterized by shortness of breath, dry cough, pleuritic pain, and blood-tinged sputum, the symptoms are actually a sign of bronchial infection or pneumonia. Lupus is notorious for inflaming the lungs, resulting in ALP, which is an inflammation of supporting tissue.
Doctors usually begin to look for ALP when symptoms do not clear up with antibiotics, and it is diagnosed via an x-ray. ALP is very serious, as 50 percent of ALP patients die within months because they were not diagnosed early enough.
Diffuse Insterstitial Lung Disease (ILD)
When ALP develops over years, ILD can develop. ILD is seen in approximately 20 percent of SLE patients. When it enters into a chronic phase, patients suffer from shallow breathing and decreased stamina. However, ILD rarely results in respiratory failure.
Over one-third of lupus patients have antiphospholipid antibodies, and one third of those patients have had a clot or thromboembolic episode at some point and time during the course of their lupus. As the blood clot settles in the lung, the pulmonary embolism will cause shortness of breath and chest pain.
Approximately 5 to 10 percent of SLE patients will have a pulmonary embolism at some point and time in the course of their disease.
While pulmonary hemorrhage occurs in only 1 percent of lupus patients, it results in 10 percent of deaths in active lupus patients.
A pulmonary hemorrhage is characterized by bleeding in the lungs that results in the patient coughing up blood. Children are very susceptible, but in adults pulmonary hemorrhage usually occurs early in the disease. In the beginning it looks like ALP, but progresses more rapidly and it is usually fatal.
About 10 to 15 percent of lupus patients suffer from pulmonary hypertension, a mildly increased pressure in pulmonary arteries, which generally has no outward symptoms.
Pulmonary hypertension can be very dangerous and life threatening if there is greater than 50mm mercury. More often, though, active inflammation can sometimes cause an increase in pulmonary pressure that results in a shortness of breath.
This was from “Freedom from Lupus”
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