Toni Braxton, the Grammy Award-winning R&B singer, has been living with systemic lupus erythematosus since her diagnosis in 2008. The chronic health condition causes inflammation and pain in any part of the body, including the skin, joints and internal organs like the kidneys and heart.
During an interview Tuesday on the "Today" show, Braxton said she almost skipped a doctor's appointment because she was feeling "fine." But she was glad that she didn't, because she was at high risk for a massive heart attack.
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Lupus increases one's risk for heart disease, including coronary artery disease, a progressive buildup of plaque in arteries. A heart attack happens when the blood flow to the heart becomes completely blocked.
Braxton, 55, said her doctor told her that she needed to have a stent – a small mesh tube – placed in one of her coronary arteries immediately. Stents are used to hold open narrowed arteries that deliver oxygen-rich blood to the heart.
Braxton, told "Today" show hosts Hoda Kotb and Jenna Bush Hager that if she hadn't gone to the doctor that day, she may have had a widowmaker, a massive heart attack caused by the total blockage of the left anterior descending artery. As the name implies, these types of heart attacks often are deadly.
She admitted to having some chest pain that in retrospect was a warning sign, but at the time she chalked it up to the grief she had been feeling since her sister Traci died in March 2022.
"I just thought it was just sadness," Braxton said. "It turned out to be much more serious, and I just dismissed the signs ... and a lot of people tend to do that."
Since 2010, Braxton has spoken publicly about the health challenges of living with lupus. She said she wanted to share her recent health scare to encourage people to get regular medical care, especially if they are living with a chronic condition like lupus.
Subtle signs of lupus
Lupus is considered an autoimmune disease, which means the immune system attacks one's body, causing damage to healthy tissue, instead of attacking pathogens like viruses and bacteria. There is no cure, but medication and lifestyle changes can slow progression of the disease.
Common medications prescribed to treat lupus include corticosteroids, antimalarials, biologics, immunosuppressive drugs like cyclophosphamide and non-steroidal, anti-inflammatory drugs – or NSAIDS. The malaria medication hydroxychloroquine also can be taken to lessen joint pain and swelling and skin rash.
Accurately diagnosing lupus can be challenge because the initial symptoms tend to vary among patients, and many of them are similar to the those caused by other illnesses, rheumatologists say. It is not uncommon for patients to have to go to several specialists before they get the right diagnosis.
According to the Lupus Foundation of America, it takes an average of nearly six years for people with lupus to be diagnosed after they first start to experience symptoms. In a survey of lupus patients, 63% had received incorrect diagnoses at first, and more than half had to see four or more specialists before the right diagnosis was found.
Rheumatologists with the Geelong Medical Center in Victoria, Australia, says subtle signs of lupus include a butterfly-shaped rash on the face, a persistent fever, rashes or sores on the skin after being outside, stiff or sore joints, swollen lymph nodes or swelling in the legs, fatigue, hair loss and pain when people cough or breathe.
Some people with lupus also experience Raynaud's, a syndrome that causes a blood circulation problem, especially when they are cold or under stress. Restricted blood flow causes their fingers or toes or both to go numb and turn blue or white. Mouth sores, migraines, brain fog and difficulties with memory and concentration also may be signs of lupus. So could the appearance of little red blood spots on the legs. The red dots, known as petechiae, develop when the lupus starts to attack platelets, affecting the body's ability to form clots to stop bleeding. Lupus also can increase the risk of having a stroke or a pulmonary embolism.
Though anyone can develop lupus, 9 of 10 people with lupus are women. Those considered at highest risk are women ages 15 to 44, people with a family history of lupus or other autoimmune diseases, and people who are African American, Hispanic/Latino, Native American or Pacific Islander. Environmental factors, viruses and infections also can be triggers.
There is no single test to diagnose lupus, but the U.S. Centers for Disease Control and Prevention says that a doctor can use a combination of medical history, physical exams and blood tests for certain antibodies. A skin or kidney biopsy also can show signs of an autoimmune disease.