Monica Mariana Băluţă, MM Vintilă
Abstract
Systemic lupus erythematosus (SLE) is an acquired connective tissue disease of unknown origin. SLE may determine rheumatic heart disease among many other systemic involvements. Any cardiac structure such as pericardium, myocardium, heart valves, the conduction system and the vasculature may be involved. Cardiovascular involvement may vary from subclinical to clinical with various complications that determine an increased morbidity and mortality in affected patients. The underlying diseases have plurifactorial etiologies among which inflammation plays a key role. Inflammation is a common pathway for rheumatic diseases and atherosclerosis, the main killer of the 21th century. Systemic lupus erythematosus (SLE) is known today as an important nontraditional risk factor for atherosclerosis. The treatment of cardiovascular involvement in SLE patients remains controversial and provocative. Nonsteroidal anti-inflammatory drugs increase the risk for cardiovascular adverse outcome. Even if old-fashioned, corticosteroids represent even today a “rescue” therapy for life-threatening SLE related cardiovascular conditions. Despite many controversies in literature about them, no other drug has been proved as safe and as effective as they can be in cardiovascular involvement. Besides the specific SLE treatment, cardiovascular involvements benefit from guideline recommended therapies for specific conditions established by international societies. Proper and early recognition together with aggressive treatment of the underlying rheumatic disease may prevent the development of cardiovascular involvement.