Document Detail


Ischemic heart disease in systemic lupus erythematosus in the young patient: report of six cases.
MedLine Citation:
PMID:  6977269     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To clarify the clinical spectrum of coronary arterial abnormalities in systemic lupus erythematosus, the data were reviewed on six patients who had a diagnosis of lupus at ages 15 to 29 years and who had ischemic heart disease before age 35. Two patients had coronary arteritis diagnosed on postmortem examination. In a third patient alterations in coronary arterial anatomy occurred with angiographic improvement temporally related to the initiation of steroid therapy. The other three patients had severe diffuse atherosclerotic coronary disease that was identified in two at postmortem examination. In the third patient the course of the disease strongly suggested coronary atherosclerosis, and eventually coronary bypass grafting was performed for relief of angina. In summary, clinically important extramural coronary arteritis and atherosclerosis both occur, although rarely, in young patients with lupus. Coronary artery disease may occur with or without coexisting active extracardiac lupus manifestations. Short-term steroid therapy and follow-up angiography for those with angina and in whom coronary arteritis is suspected warrant consideration. When stable coronary arterial anatomy is demonstrated on follow-up angiography, management is determined by the patient's symptoms irrespective of the prior history of lupus and, if indicated, cardiac surgery for symptomatic relief can be safely performed.
Authors:
C J Homcy; R R Liberthson; J T Fallon; S Gross; L M Miller
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American journal of cardiology     Volume:  49     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1982 Feb 
Date Detail:
Created Date:  1982-04-12     Completed Date:  1982-04-12     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  478-84     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Factors
Angina Pectoris / complications,  drug therapy,  surgery
Arteritis / complications,  radiography,  surgery
Coronary Angiography
Coronary Artery Bypass
Coronary Disease / complications*,  radiography,  surgery
Coronary Vessels / surgery
Female
Humans
Lupus Erythematosus, Systemic / complications*,  radiography,  surgery
Prednisone / therapeutic use
Grant Support
ID/Acronym/Agency:
HL-26215/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
53-03-2/Prednisone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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