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Coronary artery disease in young patients with systemic lupus erythematosus: two case reports

Ettore Astorri1, Paolo Pattoneri, Arianna Arisi

  • 1Chair of Cardiology, Department of Clinical Sciences, University of Parma, Parma, Italy. ettore.astorri@unipr.it

Italian Heart Journal : Official Journal of the Italian Federation of Cardiology
|February 24, 2004
PubMed

Insights

Systemic lupus erythematosus (SLE) can affect the heart, leading to coronary artery disease in young patients. This study highlights two cases of myocardial ischemia and infarction in adolescents and young adults with SLE.

Area of Science:

  • Cardiology
  • Rheumatology
  • Immunology

Background:

  • Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with potential cardiovascular complications.
  • Cardiovascular involvement in SLE, particularly myocardial ischemia and infarction in young patients, is underreported.
  • Early recognition and management of cardiac issues in SLE are crucial for long-term outcomes.

Observation:

  • Two young patients with SLE presented with distinct clinical manifestations of coronary artery disease.
  • Case 1: A 26-year-old woman with a history of SLE experienced progressive angina, leading to the diagnosis of a completely obstructed left anterior descending artery (LAD).
  • Case 2: A patient presented with myopericarditis and acute myocardial infarction, subsequently diagnosed with SLE, also showing complete LAD obstruction.

Findings:

  • The study identified coronary artery disease, including complete LAD obstruction, in two young SLE patients.
  • Clinical presentations varied, ranging from effort angina to acute myocardial infarction and myopericarditis.
  • Diagnostic tools like myocardial scintigraphy and coronary angiography were instrumental in identifying the extent of coronary artery disease.

Implications:

  • These cases underscore the importance of considering coronary artery disease in young SLE patients presenting with cardiac symptoms.
  • Timely diagnosis and intervention, including surgical revascularization, can be effective in managing SLE-related coronary artery disease.
  • Further research is warranted to elucidate the mechanisms and prevalence of cardiovascular involvement in pediatric and young adult SLE.

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