Cardiovascular Manifestations of Systemic Lupus Erythematosus: A Practical Multimodality Imaging Approach.

Patients with systemic lupus erythematosus (SLE) are at increased risk of a wide range of cardiovascular manifestations, which contribute substantially to morbidity and mortality. Multimodality cardiovascular imaging plays a central role in the detection, characterization, and monitoring of cardiac involvement in SLE. In this review we provide an overview of the clinical presentation and imaging features of major cardiovascular manifestations in SLE, including pericardial disease, myocarditis, coronary artery disease, and valvular involvement. The strengths and limitations of echocardiography, cardiac magnetic resonance, computed tomography, and nuclear imaging techniques are discussed. For each entity, we highlight the specific imaging findings that change management, practical next test choices, and common situations where repeat imaging or escalation to another modality are helpful. Improved integration of multimodality imaging may enable earlier diagnosis, better risk stratification, and more targeted management of cardiovascular disease in patients with SLE.