Robert E. Kellum

Clinical Diagnosis of Cardiac Involvement in Systemic Lupus Erythematosus A Correlation of Clinical and Autopsy Findings in Thirty Patients

A review was made of the case histories and autopsy reports of 30 patients with systemic lupus erythematosus who had clinical cardiovascular involvement. The presence of an enlarged heart or of gallop rhythmstrongly suggests myocardial involvement, but the electrocardiogram is not specific. Signs and symptoms referable to the heart are unusual as a first manifestation of systemic lupus erythematosus, and in patients receiving suppressive chemotherapy they do not further worsen the prognosis. Systolic murmurs cannot be interpreted as conclusive evidence of Libman-Sacks valvulitis.