Cardiac involvement in lupus, systemic sclerosis and myositis is often silent until it is advanced. A few routine questions and a low threshold for an ECG catch much of it earlier.
Ask about breathlessness, chest pain, palpitations and reduced exercise tolerance, and examine for a rub or signs of heart failure. Arrange an ECG and echocardiogram if anything is new, and involve cardiology early.
- Ask about breathlessness, chest pain, palpitations and exercise tolerance at each review.
- Listen for a pericardial rub and look for signs of heart failure.
- Arrange an ECG and echocardiogram for any new cardiac symptom.
- Involve cardiology early when involvement is suspected.
Why it matters
Silent myocardial and pericardial disease is a leading cause of death in these conditions.
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