How Lupus Can Affect the Heart, Lung and Blood Vessels

Learn the different ways Lupus can affect the heart, lung and blood vessels and how to protect yourself from them.  

Lupus, also called Systemic Lupus Erythematosus (SLE) may affect the lungs, heart, and blood vessels at some point in most people with this disease. Lupus is an autoimmune condition in which the body’s immune system attacks healthy cells due to reasons not completely known. Some people are born with a tendency to develop Lupus. Lupus is more common in females and usually diagnosed when they are 15-45 years old.  

Lupus and the Lungs  

Lupus may affect the lung tissue, membranes covering the lungs (pleura), and blood vessels inside the lungs. Because of the disease causing an immunocompromised state, medications and related infections may also affect the lungs.  

  • Pneumonitis  

Lung tissue inflammation leads to a condition called Pneumonitis. This is generally brought on by infection. Symptoms include fever, shortness of breath, chest pain and cough.   

  • Interstitial Lung Disease  

Lupus can also cause scarring of the lung tissue called Interstitial Lung Disease. Interstitial lung disease may occur due to inflammation or as a side effect of certain medications. The onset of symptoms can include dry cough, shortness of breath, and fatigue.   

  • Pleuritis  

An inflammation of membranes covering the lungs (pleura) can occur in Lupus, resulting in chest pain when you breath and shortness of breath.  

  • Pulmonary Hypertension  

Involvement of blood vessels in the lungs can lead to high pressure within the blood vessels, causing Pulmonary Hypertension. The symptoms include irregular heartbeat, shortness of breath, fatigue, and fainting episodes. Raynaud’s Phenomenon, which is blue and white discoloration of the fingers during exposure to cold and stress, is usually present in 60% of people with pulmonary hypertension.  

  • Pulmonary Embolism  

There is an increased risk of blood clot formation in some people with Lupus with a condition called Antiphospholipid Antibody Syndrome. Pulmonary Embolism, a condition in which blood clots cause blockage of the arteries leading to the lung, may be evidenced by sudden shortness of breath or chest pain that worsens with breathing.   

Lupus and the Heart 

  • Coronary Artery Disease and Heart Attack  

Atherosclerosis, a condition with plaque formation in the arteries, is common in people with Lupus. Atherosclerosis that affects coronary arteries (arteries supplying the heart), called Coronary Artery Disease, increases the risk of decreased blood flow to the heart. A heart attack occurs when the blood flow to the heart is completely blocked. The symptoms of a heart attack can be typical (chest pain or pressure that spreads to the left arm or jaw), or nonspecific (shortness of breath and excessive sweating), while missing the classic chest pain that is typical of a heart attack.  

The traditional risk factors of atherosclerosis (high lipids, sedentary lifestyle, high blood pressure and obesity) may be caused by Lupus itself or steroid treatment.  

  • Endocarditis  

Endocarditis, or inflammation of the heart valves and the lining of the inner chambers, can lead to clumps of material buildup on the valves. These clumps can break loose and travel, affecting other organs.  

  • Myocarditis  

Inflammation of the heart muscle can cause myocarditis, which may affect the heart’s ability to pump. Symptoms include chest pain, rapid and irregular heartbeat, shortness of breath, and swelling of legs, ankles, and feet.  

  • Pericarditis  

The sac-like tissue surrounding the heart, called the pericardium, can be involved. This causes sharp or stabbing chest pain behind the breastbone or inside the left side, which improves when sitting up and leaning forward. The chest pain worsens with deep breath, coughing, and when lying down. Other symptoms are shortness of breath, low-grade fever, and coughing.  

Lupus and blood vessels 

Lupus may cause inflammation of blood vessels of any size. Skin or small vessel inflammation can lead to symptoms such as ecchymoses, bruises, or pinpoint round spots. Blood vessel involvement of the skin can also cause Raynaud’s Phenomenon, characterized by blue or white discoloration of fingers due to cold temperature or emotional stress.  

Blood vessels supplying the liver, pancreas, and intestines may also be affected with related symptoms.  

Antiphospholipid Antibody Syndrome can increase the risk of blood clots in the blood vessels. This causes serious complications, such as stroke, heart attack, and pulmonary embolism.  

Steps to protect your heart, lungs and blood vessels  

  • Eat a healthy, balanced, nutritious diet that is rich in vegetables fruits, and whole grains. Make sure you consume no more than 1,500 mg of salt per day, especially if you have high blood pressure and/or kidney disease.  

Actions to take if you have high cholesterol are:  

  • Include legumes, whole grains, fruits, vegetables and plant oil in your diet.  
  • Include certain beans (lentils or navy, pinto or black bean) in your diet.  
  • Consume nuts that are high in mono- or polyunsaturated fatty acids (particularly walnuts, almonds, pistachios, macadamia nuts, pecans and hazelnuts).  
  • Include foods that are rich in Omega-3 FA-fatty fish (especially salmon, herring, mackerel and trout), and fish oil and plant products, such as flaxseed, chia seeds, canola oil, soybean oil and some nuts.  
  • Reduce consumption of saturated fat, including butter, ghee, lard, coconut oil, cakes, biscuits, pastries, cheese, cream and ice cream.  
  • If you smoke, plan to quit immediately. Smoking is not only one of the risk factors of atherosclerosis, but it is also associated with active Lupus, which may affect various organs. Smoking also reduces the efficacy of Hydroxychloroquine, a widely used medication for treating Lupus.  
  • Get regular physical activity to stay fit and reduce fatigue. Physical activity is beneficial in reducing weight, blood pressure and cholesterol, all risk factors for heart disease.  
  • Talk to your doctor regarding taking daily low-dose aspirin. Because of its anti-clotting ability, aspirin can help prevent heart attacks. 
  • Make sure you keep all appointments with your doctor and healthcare team who regularly will monitor your disease progression.  

The takeaway message  

Lupus can affect people in different ways. Symptoms may arise suddenly or develop slowly. It is important to understand the implications of uncontrolled inflammation, know the side effects of medications and take precautionary measures to control the inflammation.   

The more you know, the more equipped and confident you are in managing Lupus. Since all medications have side effects, actively participate in your treatment plan by having regular discussions with your healthcare team. Be sure to inform them immediately if you experience any side effects or symptoms.  

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