tailieunhanh - Heart Disease in Pregnancy - part 5

hội chứng chống phospholipid (APS), có thể xảy ra trong bối cảnh của SLE, các bệnh tự miễn khác hoặc là chính tim thường tham gia vào Viêm màng ngoài tim là biểu hiện tim mạch thường gặp nhất của bệnh lupus và không thể phân biệt các hình thức khác viêm màng ngoài tim cấp tính | 138 Chapter 11 anti-phospholipid syndrome APS which can occur in the context of SLE other autoimmune diseases or as primary The heart is often involved in Pericarditis is the most frequent cardiac manifestation of lupus and is indistinguishable from other forms of acute pericarditis. It is usually recurrent associated with pleural disease and characteristically shows low complement levels in the pericardial fluid. Lupus serositis usually responds well to steroids and antimalarials. Valvular disease has a strong association with the presence of aPLs. The mitral and aortic valves are the most frequently involved regurgitation being more common than stenosis. The severity of valve disease is variable sometimes leading to frank hemodynamic compromise that requires a surgical approach. Systemic emboli are another potential complication of valve lesions in SLE and APS. Medical management is not well established because neither corticosteroids nor anti-thrombotic anticoagulant drugs have shown clear efficacy in preventing Many patients experience eventual hemodynamic deterioration that requires surgical valve Cardiac surgery may be particularly complicated in these patients with an increased frequency of thromboembolic complications and late structural deterioration of the prosthetic Lupus patients are at increased risk of coronary artery Atherosclerosis is more prevalent in this group12 and coronary thrombosis has been described in the context of Strict control of vascular risk factors along with anti-thrombotic therapy in aPL-positive lupus patients and anticoagulation in those with APS and any form of thrombosis is Recent data point to a protective effect of antimalarials against Pulmonary hypertension PHT is a rare but potentially lethal complication of SLE and The exact prevalence in both conditions is not well defined however severe symptomatic forms are .