Lupus Chest Pain and Pericarditis
Lupus patients can also suffer from chest pain known as pericarditis, which is the inflammation of the sac that surrounds your heart. Like myocarditis, it can be extremely scary and painful but typically does not present an immediate threat.
Pericarditis, however, can have a lasting effect if the inflammation cannot be kept under control. It can make it difficult for the heart to pump blood if the sac is continuously inflamed, leading to further issues with the heart itself.
While pericarditis and myocarditis are rarely life-threatening, unless they cannot be controlled long-term, there are times when chest pain can be a problem.
If you regularly experience pericarditis or myocarditis and suddenly experience pain that feels more intense or different, it is advised that you visit the local emergency room immediately. It can be due to a number of things, including a heart attack, blood clot or coronary artery disease.
Symptoms of Pericarditis
There are several types of pericarditis:
- Acute pericarditis, where the pain lasts up to three weeks.
- Incessant pericarditis, where the pain lasts four to six weeks, is continuous but resolves within three months.
- Recurrent pericarditis, where the pain lasts four to six weeks, resolves completely, but then recurs.
- Chronic pericarditis, where the pain lasts longer than three months.
The obvious symptom associated with pericarditis is chest pain, as the inflammation causes pain. This pain is often described as “sharp, stabbing chest pain behind the breastbone or in the left side of your chest”, but it can also feel dull and achy.
Other symptoms associated with pericarditis include:
- Shortness of breath, especially while in a reclined position.
- Heart palpitations.
- Abdominal and/or leg swelling.
- A cough.
- Low-grade fever.
- A feeling of malaise.
Treatment of Pericarditis
One of the best things you can do to treat pericarditis is to manage your lupus – treating lupus as prescribed will decrease inflammation in general.
However, you must notify your physician if your symptoms worsen because there are steps that should be taken to ensure that pericarditis does not become an emergency situation.
Initially, your physician will most likely prescribe medications to reduce inflammation. You may already be taking some of these medications to treat lupus, but some examples include NSAIDs such as aspirin and ibuprofen, corticosteroids such as prednisone, and colchicine. Colchicine is a medication that is often prescribed during acute phases of pericarditis but also may treat recurrent symptoms.
During rare instances, you may need hospitalization. A hospitalization is required if your physician suspects one of the complications listed below. In that case, surgical procedures are typically performed to remove the excess fluid from around the heart, such as a pericardiocentesis, or a pericardectomy, which removes the pericardium.
Complications of Pericarditis
Again, complications of pericarditis are probably rare unless you do not treat your lupus or ignore the warning signs, but it is a great idea to know these complications:
- Constrictive pericarditis. This is a rare complication of pericarditis and is typically associated with long-term inflammation and pericarditis that continually recurs. Constrictive pericarditis is when permanent thickening and scarring occurs of the pericardium, causing it to lose its elasticity. It makes the heart unable to function properly, causing severe swelling of the abdomen and lower extremities, and shortness of breath.
- Cardiac tamponade. This is an emergency situation. Cardiac tamponade occurs when excess fluid collects in the pericardium. This fluid exerts pressure on the heart, making it difficult to breathe. It causes a dangerous drop in blood pressure because there is a decrease in blood that is pumped from the heart.
Other Lupus Chest Pain and Heart Issues
People with lupus can be susceptible to endocarditis, which involves the inflammation of the heart valve, which will eventually cause it to thicken.
The inflammation can also cause lesions in the heart that can become infected, creating a life-threatening problem, or that can even break off. If a lesion travels to the brain, it can cause a blood clot, which is also potentially life-threatening.
Additionally, those with lupus often have coronary artery disease, particularly as a result of steroid use. This risk increases if you have high blood pressure or high cholesterol from prolonged use of steroids.
With coronary artery disease, plaque can build up in the blood vessels, which will cause the blood flow to your heart and arteries to restrict. This, in turn, can create pain known as angina.
However, over time, plaque can break off which can put you at risk for a heart attack.
Any time you, as a lupus patient, experience severe lupus chest pain of unknown origin, it is critical that you speak to your doctor or go to the emergency room. Although many times it is nothing serious, you can still find yourself becoming incredibly ill if you don’t take precautions and take your health seriously.