• Like
  • Save
SLE  and cardiovascular manifestations
Upcoming SlideShare
Loading in...5

SLE and cardiovascular manifestations



for more cardiology ppts visit regularly

for more cardiology ppts visit regularly



Total Views
Views on SlideShare
Embed Views



2 Embeds 55

http://cardiologysearch.blogspot.in 54
http://cardiologysearch.blogspot.com 1


Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.


12 of 2

  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
Post Comment
Edit your comment

    SLE  and cardiovascular manifestations SLE and cardiovascular manifestations Presentation Transcript

    • http://cardiologysearch.blogspot.in/http://cardiologysearch.blogspot.in/ http://cardiologysearch.blogspot.in/
    •  Cardiac disease is common among patients with systemic lupus erythematosus (SLE) as  pericardial,  myocardial,  valvular and  coronary artery involvement http://cardiologysearch.blogspot.in/
    • http://cardiologysearch.blogspot.in/
    • http://cardiologysearch.blogspot.in/
    • http://cardiologysearch.blogspot.in/
    •  Pericardial involvement is the  Pericardial effusion  pericarditis  second most common echocardiographic lesion in SLE, and  most frequent cause of symptomatic cardiac disease. http://cardiologysearch.blogspot.in/
    •  Conduction defects, Represent a sequel of active or past pericarditis and/or myocarditis noted in 34 to 70 % of patients with SLE. First-degree heart block may be seen and is often transient http://cardiologysearch.blogspot.in/
    •  Congenital heart block may be part of the neonatal lupus syndrome. The resting heart rate may correlate with disease activity. Study 14 of 15 patients with a resting heart rate above 90 beats/min had active disease http://cardiologysearch.blogspot.in/
    •  Mitral valve involvement is most common; Mild to moderate regurgitant murmur may be heard but most patients remain asymptomatic Mitral valve prolapse in 25 percent of cases. Verrucous endocarditis — Libman-Sacks (verrucous) endocarditis http://cardiologysearch.blogspot.in/
    •  MYOCARDITIS  uncommon,  asymptomatic manifestation of SLE  prevalence of 8 to 25 % in different studies http://cardiologysearch.blogspot.in/
    •  Acute myocarditis infiltration of the myocardium with mononuclear cells. Resolution of the inflammation leads to fibrosis that may be manifested clinically as dilated cardiomyopathy. http://cardiologysearch.blogspot.in/
    • 1. Coronary artery involvement is the most recent cardiovascular manifestation to be recognized in SLE 2. seen in 2 – 16 % of patients with SLE 3. can lead to acute myocardial infarction in young women. In some cases, thrombi rather than coronary disease is responsible for the ischemia . Coronary artery vasculitis is rare. http://cardiologysearch.blogspot.in/
    • Other coronary artery manifestations - Coronary arteritis, Aneurysms, Vasospasm Embolic phenomenon http://cardiologysearch.blogspot.in/
    • Presentation Angina, Myocardial infarction, Sudden death Responsible for 0.3 % deaths. http://cardiologysearch.blogspot.in/
    • http://cardiologysearch.blogspot.in/
    • Pathogenesis http://cardiologysearch.blogspot.in/
    • Risk Factorshttp://cardiologysearch.blogspot.in/
    •  Most striking feature of CAD in SLE is the  predilection for young premenopausal women. Manzi and colleagues  lupus women aged 35 to 44 years were over 50 times more likely to have an MI as compared to controls. http://cardiologysearch.blogspot.in/
    •  modifiable risk factor for occlusive vascular disease in both general and lupus populations. Elevated homocysteine levels have been reported in 15% of lupus patients Associated with  cardiovascular events  subclinical atherosclerosis http://cardiologysearch.blogspot.in/
    • http://cardiologysearch.blogspot.in/
    •  43 yr old female A known case of SLE ANA positive On steroids http://cardiologysearch.blogspot.in/
    •  OBESITY SYSTEMIC HYPERTENSION ANEMIA Acid peptic disease Hypothyroidism Nephropathy Hemorrhoids http://cardiologysearch.blogspot.in/
    •  Old IWMI CAG-2003  Mild CAD  Mild LAD and RCA disease http://cardiologysearch.blogspot.in/
    •  Acute coronary syndrome AWMI – delayed presentation Not Thrombolised Patient managed and stabilized Taken for CAG http://cardiologysearch.blogspot.in/
    •  Right dominant system Two vessel disease Significant proximal LAD disease Critical mid RCA disease Major diagonal disease http://cardiologysearch.blogspot.in/
    •  Hypokinetic IVS, apical segments. Anterolateral segments Mild LV dysfunction EF -65 % Grade I – diastolic dysfunction http://cardiologysearch.blogspot.in/
    •  Advised CABG SURGERY with grafts to  Distal LAD  Major diagonal  Distal RCA OR PCI to LAD and RCA - IF considered high risk for CABG http://cardiologysearch.blogspot.in/
    •  Discussed with CT surgeons and anesthetists Due to Presence of  high risk profile  Symptomatic status – class III symptoms  Nephropathy – high creatinine values, cr -2.7 mg%  Patient taken for PCI http://cardiologysearch.blogspot.in/
    •  Drug eluting stent placed in  LAD -SUPRALIMUS CORE STENT  RCA - ENDEAVOR STENT Patient was started on antiplatelets http://cardiologysearch.blogspot.in/
    • http://cardiologysearch.blogspot.in/
    • http://cardiologysearch.blogspot.in/
    •  Patient developed GI –bleeding Coffee ground vomitting Profound hypotension Patient became unconscious http://cardiologysearch.blogspot.in/
    •  Blood transfusion Fluid replacement Inotrops – dopamine. Adrenaline infusion started Patient ABG - desaturation http://cardiologysearch.blogspot.in/
    •  Patient connected to mechanical ventilator Antiplatelets stopped- inspite of DES Continuous Pantoprazole infusion started http://cardiologysearch.blogspot.in/
    •  Active bleeding stopped - after 3 days Hemodynamic stability attained CLOPIDOGREL antiplatelet- started after 3 days Aspirin also restarted by 5 days http://cardiologysearch.blogspot.in/
    •  Patient improved in 5 days Shifted to ward and discharged http://cardiologysearch.blogspot.in/
    •  Blood disorder  NSAIDS – used for different symptoms in SLE ▪ Increase bleeding  Corticosteroids – produce peptic ulcer  Thrombocytopenia – increase bleeding ▪ Autoimmune ▪ Drug induced  Antiphospholipid antibody – increase thrombosis ▪ Increase chance of stent thrombosis http://cardiologysearch.blogspot.in/
    • Bleeding Stent thrombosis Anti platelets http://cardiologysearch.blogspot.in/
    • http://cardiologysearch.blogspot.in/
    •  Kindly send your suggestions to improve this site Visit us regularly for updates Send your articles/ ppt/pdf to publish in this site . http://cardiologysearch.blogspot.in/