Background and Aims Cardiac involvement among pSLE patients is a known complications. Early diagnosis and treatment of pSLE cardiac complications is crucial, as they may carry poor prognosis.We are reporting the prevalence and different types of cardiovascular complications in Saudi Arabian patients with pSLE.

Methods 46 pSLE patients (6 to 19 years) were following from January 2014 to September 2015 at the rheumatology clinic of King Abdul-Aziz University Hospital, Jeddah. Laboratory data such as CRP, ANA, anti-dsDNA, C3 and C4 complements, were collected. Cardiac evaluation included chest x-ray, ECG, and echocardiography, along with estimation of SLE activity by calculating the SLE Disease Activity Index (SLEDAI) score according to SELENA Modification

Results Prevalence of cardiac manifestations was 47.8%, occurring at a mean±SD age of 14.0±2.28 years. Valvular heart diseases were detected in 16 (34.8%) cases, followed by pericarditis in 6 (13%), and silent valvular diseases in 8 (17.4%) cases. Of the 16 valvular diseases, tricuspid and pulmonary valves were involved in 9 and 8 cases, respectively. Cardiac involvement was silent in 36.4% and occurred as an initial presenting symptom of SLE in 9.1% cases. Biologically, patients with cardiac involvement had higher levels of CRP and anti dsDNA, and lower levels of complement C3 compared to patients with no cardiac involvement; while SLE activity was the only significant predictor for cardiac involvement (Beta=0.654; p=0.020)

Conclusions Cardiac complications are common (1 out of 3 times). They are predicted by high SLE activity and anti-dsDNA, CRP and low C3 levels. Reguiar echocardiography is erommended for Patients with high SLE activity.