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Complete heart block and systemic lupus erythematosus.
British Heart Journal
|September 1, 1975
Summary
Systemic lupus erythematosus can cause severe heart problems, leading to complete heart block. This case highlights the long-term cardiac complications and successful pacemaker implantation in a young patient.
Area of Science:
- Cardiology
- Rheumatology
- Immunology
Background:
- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical manifestations.
- Cardiac involvement in SLE can range from pericarditis to myocarditis and conduction abnormalities.
- Long-term monitoring is crucial for identifying progressive cardiac complications in SLE patients.
Observation:
- An 18-year-old female with a known diagnosis of SLE presented with a 16-year history of progressive electrocardiographic (ECG) abnormalities.
- The patient experienced recurrent Adams-Stokes attacks, indicative of severe bradyarrhythmia.
- The ECG changes evolved over years, suggesting a chronic and progressive cardiac process linked to SLE.
Findings:
- The culmination of ECG abnormalities was complete atrioventricular (AV) block.
- This complete heart block led to life-threatening Adams-Stokes syncope.
- The patient required intervention to manage the severe bradycardia and prevent further syncopal episodes.
Implications:
- This case underscores the potential for severe, progressive cardiac conduction disease in SLE.
- Early recognition and management of cardiac manifestations in SLE are critical for patient outcomes.
- Successful implantation of a permanent ventricular pacing system provided a definitive solution for the patient's life-threatening condition.