Lupus can cause inflammation of the pericardium, the lining around your heart. Depending on the severity of your symptoms, treatments range from over-the-counter pain relievers to surgery.

Systemic lupus erythematosus (SLE), the most common form of lupus, can cause chronic inflammation and damage to several areas of the body, including your heart. Certain lupus treatments may also increase your risk of developing heart complications.

SLE can affect your heart in several ways, including causing inflammation of the lining surrounding your heart (pericardium). This is better known as pericarditis.

Learn more about lupus pericarditis to see if you may be at risk of developing this heart complication and what a doctor might recommend to help prevent and treat it.

Autoimmune diseases such as lupus and scleroderma can increase your risk of developing pericarditis. Like other autoimmune conditions, lupus is characterized by an overactive immune system that mistakes healthy tissues and cells for invasive ones, thereby attacking them.

With lupus pericarditis, your immune system may mistakenly attack tissues surrounding your heart. Pericarditis develops due to inflammation of the sac, or lining, that protects your heart.

Over time, inflammation and damage from lupus can affect your blood vessels and your heart, leading to other problems such as coronary artery disease (CAD) and myocarditis.

Aside from inflammation, lupus pericarditis may also result from long-term steroid treatments for lupus. Due to their possible contributions to heart disease, doctors only recommended steroids at the lowest effective dose and for the shortest amount of time possible.

While lupus is more common in females, pericarditis is most common in males ages 16–65. Being male and receiving a lupus diagnosis at a young age could increase your risk of pericarditis, according to a 2019 review.

Non-lupus-related causes of pericarditis may include viral infections, injuries, and kidney disease.

Cardiovascular complications of lupus

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The pericardium consists of two layers surrounding the outside of your heart, and it resembles a protective sac. Its purpose is to help protect your heart and hold it in place. As these tissues break down, your heart may rub against them, causing symptoms from friction.

Most people with lupus pericarditis don’t have symptoms of pericardial involvement. However, possible symptoms may include:

If you’re experiencing chest pain, call 911 or your local emergency services. Since chest pain is also a common symptom of a heart attack, it’s important that a doctor evaluates your symptoms to rule this out.

Obtaining a proper diagnosis from a doctor is essential, as some of these symptoms are typical of other heart and lung issues.

Symptoms of pericarditis may worsen during a lupus flare. This means you may also experience worsening lupus symptoms, such as fatigue, rashes, or joint pain.

The goal of lupus treatment and management is to help reduce the risk of complications such as pericarditis. However, if they suspect heart issues, a primary doctor or cardiologist may run the following diagnostic tests:

Also, as a 2022 case series reported, symptoms of acute pericarditis can be present before you receive a lupus diagnosis.

How common is lupus pericarditis?

Research suggests that pericarditis is a common cardiovascular complication of lupus, particularly affecting the outer or “fibrous” layer of the pericardium. In fact, about half of all people with lupus may have chronic pericarditis.

Endocarditis (inflammation of the heart’s inner lining) is also common in lupus, but myocarditis (inflammation of heart tissue) is rare.

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Treatment for pericarditis consists of managing symptoms while also addressing the underlying cause. Regular checkups with your doctor can help them determine whether changes are needed to your lupus treatment plan.

To treat chest pain and discomfort, a doctor may recommend over-the-counter pain relievers, such as ibuprofen (Advil, Aleve). However, if you have kidney problems related to lupus, a doctor might have you avoid these medications.

For more severe symptoms, a doctor may prescribe steroids or stronger anti-inflammatories like colchicine.

Treatment for lupus pericarditis may last longer than 3 months.

In more severe cases of pericarditis, fluid may build up outside of your heart. This may require pericardiocentesis to remove fluid and reduce symptoms. As a last resort, a doctor might recommend removing your pericardium (pericardiectomy).

Additionally, a doctor will likely recommend a heart-healthy lifestyle, which can include the following:

Most cases of pericarditis are mild and acute (short-term). However, if you have lupus, you may be at a higher risk of developing recurring or chronic pericarditis.

Over time, pericarditis can cause potentially life threatening complications. While rare in lupus, this may include heart compression from fluid buildup around the pericardium (cardiac tamponade).

If steroid use is contributing to lupus pericarditis, a doctor may consider adjusting your medications. Adjustments might involve some trial and error as a doctor determines the lowest doses needed to help prevent lupus flares.

While the overall outlook for lupus has improved in recent years thanks to advancements in treatment, cardiovascular-related complications are among some of the leading causes of death among people with this autoimmune disease.

Pericarditis is a common heart-related complication of lupus that occurs when long-term inflammation or use of certain lupus medications leads to a breakdown of tissues within the pericardium surrounding your heart.

If you have any new symptoms of chest pain or shortness of breath, it’s important to see a doctor right away. They will run tests to determine whether these are related to a heart condition like lupus pericarditis.

Since lupus pericarditis is often asymptomatic, a doctor will likely recommend regular heart health screenings to help detect potential issues like pericarditis early.