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Self-Assessment Questions

Rheumatology


Answer 3
  1. Echocardiogram. Serositis in SLE can involve the pericardial, pleural, or gastrointestinal serosal surfaces. Pericarditis is the most frequent cardiac manifestation of SLE, and presentation can range from small to large effusions that can increase gradually or rapidly. Although tamponade is rare, it must be considered in any patient who presents with symptoms of cardiac compromise. Generally, the most accessible means of evaluation is echocardiogram. Treatment will include steroids, but in this degree of illness, the preferred dose is 1000 mg methylprednisolone daily for 3 days. Nonsteroidal anti-inflammatory drugs are an adjunctive therapy in serosal inflammation but are not sufficient for primary treatment. Diuresis would be dangerous, as cardiac output is dependent on the right ventricular filling pressure. Pulse oximetry would be sufficient to estimate oxygen saturation; an arterial blood gas is not necessary at this point.

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