The heart in systemic lupus erythematosus.

Systemic lupus erythematosus was originally described by a dermatologist (Kaposi, 1872). The cardiac manifestations of this disease were first noticed by Libman in 1911 and published with Sacks in 1924 (4 cases). Recognition of the full clinical picture and of the interrelationship of the various aspects of the disease was achieved by the Mt. Sinai group in the years 1923-1935 (see Baehr et al., 1935). The first account of the pathology of the cardiac lesions was based on 11 cases (Gross, 1932). Systemic lupus erythematosus appears to be less common in the British Isles than in the U.S.A., but it has received more attention here in recent years. With wider recognition of the disease the incidence of heart damage has been found to be greater: Humphreys (1948) found cardiac abnormalities in most of 21 cases studied at necropsy, and Harvey et al. (1954) found that 55 per cent of 138 patients had cardiac abnormalities at some stage of their illness, the commonest finding being pericarditis. Our own observations also show a high incidence of cardiac abnormalities in systemic lupus erythematosus. Heart lesions develop in nearly all patients at some time during the course of their disease when life is prolonged by modern antibiotic and steroid therapy.