Lupus is a serious autoimmune disease that can cause inflammation throughout your body. This inflammation can damage a wide range of organs and tissues, including your heart. Heart disease is one of the major complications that people with lupus need to worry about. One of the many heart conditions that lupus sufferers are at risk of is Libman-Sacks endocarditis; here are five things you need to know about it.
What is Libman-Sacks endocarditis?
Libman-sacks endocarditis is characterized by the presence of verrucous (warty) lesions on the endocardium, as well as inflammation of this tissue. The endocardium is the tissue that lines the inside of your heart. This tissue is very important since it controls the function of your heart muscles, and when it's inflamed, it can't do its job as well. Your heart needs to work harder to pump blood around your body, which wears it out and can lead to heart failure.
What are the signs of Libman-Sacks endocarditis?
Usually, people with Libman-Sacks endocarditis either have no symptoms or have only minor functional limitations. Your doctor may notice abnormalities in your heart during a routine exam, such as a heart murmur, and follow-up testing such as echocardiography will diagnose the problem. Routine echocardiography may also be performed to ensure that asymptomatic heart issues are not developing.
Sometimes, symptoms are present. These symptoms may include the following:
- Tachycardia (a faster than normal heart rate);
- Embolic phenomenon (blood clots);
If you notice any of these symptoms, make sure to seek treatment right away. However, don't assume that your heart is fine just because you don't have any symptoms.
How does lupus cause this disease?
Doctors still aren't sure how lupus leads to Libman-Sacks endocarditis. The current theory is that antiphospholipid antibodies play a role. Antiphospholipid antibodies are autoimmune cells that mistakenly target your blood, which can lead to blood clots. These antibodies have also been linked to abnormalities of the heart valves, and may contribute to the development of the verrucous lesions found in Libman-Sacks endocarditis.
However, not everyone has antiphospholipid antibodies. Lupus patients who don't have them develop valvular disease at the same rate as people who have the antibodies. More research needs to be performed to figure out the role that these antibodies play and to identify other possible causes.
Is this disease a common complication of lupus?
Libman-Sacks endocarditis is common among people with lupus. One study used Doppler echocardiography to examine the hearts of 342 lupus patients, and 38 of them (11%) had Libman-Sacks endocarditis. The study found that both disease duration and activity were strongly associated with developing endocarditis, so if you've had lupus for a long time or if your disease is active, you may have a higher risk.
How is Libman-Sacks endocarditis treated?
Libman-Sacks endocarditis can be treated with medications like vasodilators or beta blockers. Vasodilators dilate your blood vessels while beta blockers help to regular your heart rhythm, and both can be used to prevent the complications of this condition. Corticosteroids can also be used to reduce the inflammation in your endocardium, though corticosteroids also have side effects, like dysfunction of the heart valves.
If your valves are severely damaged by the lesions, you may need valve surgery. During this surgery, your diseased valves will be removed and replaced with mechanical prostheses. This surgery is very dangerous for people with lupus, and mortality rates are as high as 25%, so it tends to be a last-resort procedure.
If you have lupus, stay alert for signs of heart disease and make sure to see your doctor regularly so that asymptomatic heart disease can be identified. For more information, talk to a doctor like Friedrich Tomas J MD.