This well-known disorder may cause rare cardiac lesions. Pericardial lesions occur in more than 30% of patients, but significant pericarditis is manifested in less than 20%. The initial manifestation of lupus erythematosus (LE) may be pericarditis, but pericardial involvement may occur at any stage of the disease. Cardiac tamponade may be caused by pericardial effusion.
Acute myocarditis is a rare complication. Arteritis of coronary arteries may cause chest pain of acute coro¬nary syndrome and rarely results in acute myocardial infarction. Conduction abnormalities rarely cause heart block requiring a pacemaker. Arrhythmias may require antiarrhythmic therapy.
Valvular disease may occur as thickening of valve struc¬tures and vegetations (Libman-Sacks noninfective endo¬carditis) are rare but characteristic lesions. Vegetations are generally located on the atrial side of the mitral valve and the arterial side of the aortic valve. They are usually immobile and thus rarely embolize to cause a mini stroke. Cardiovascular complications and renal disease are the most common cause of mortality (see the chapter Blood Clots).