When systemic lupus erythematosus, a chronic autoimmune disease where the immune system attacks healthy tissue gets out of control, it doesn’t just hurt your joints or skin—it can quietly wreck your heart. This isn’t rare. Up to half of people with lupus develop some form of heart involvement, often without obvious symptoms until it’s advanced. The immune system, confused and overactive, starts attacking the lining around the heart, the heart muscle itself, or even the blood vessels feeding it. This is lupus cardiomyopathy, a direct effect of lupus inflammation on heart muscle tissue, and it’s one of the leading causes of death in lupus patients after infections.
It’s not just the muscle. The pericardium, the thin sac surrounding the heart can swell and fill with fluid, causing sharp chest pain that gets worse when you lie down. Coronary arteries can get inflamed too, speeding up plaque buildup and raising your risk of heart attack—even in young people who don’t smoke or have high cholesterol. Lupus also makes blood clot more easily, which means you’re at higher risk for strokes and pulmonary embolisms. And if you’re taking steroids long-term to manage lupus, that adds more pressure on your heart, raising blood pressure and cholesterol. These aren’t side effects you can ignore—they’re part of the disease itself.
What makes this worse is how sneaky it is. You might feel fine, but your heart could be quietly weakening. Routine EKGs and echocardiograms don’t always catch early damage. That’s why people with lupus need more than just symptom checks—they need regular heart monitoring, even if they feel great. Blood tests for inflammation markers like CRP and troponin, along with imaging, help spot trouble before it’s too late. Lifestyle changes matter too: quitting smoking, controlling blood pressure, eating less salt, and staying active all help protect your heart. Medications like hydroxychloroquine don’t just calm your immune system—they also lower your risk of heart disease by improving cholesterol and reducing clotting.
There’s no magic cure, but catching heart damage early gives you the best shot at stopping it. The posts below cover real cases, drug interactions that worsen heart risks, which medications to avoid, and how to track your heart health without waiting for a crisis. You’ll find practical advice on what tests to ask for, how to recognize warning signs others miss, and what treatments actually work when lupus targets your heart. This isn’t just about managing lupus—it’s about keeping your heart alive while you do it.
