Cardiac tamponade: an initial presentation of SLE

Area of Science:

• Cardiology
• Nephrology
• Rheumatology

Background:

• Systemic lupus erythematosus (SLE) is a chronic autoimmune disease.
• SLE can affect multiple organ systems, including the heart and kidneys.
• Nephrotic syndrome and pericardial effusion are potential severe manifestations of SLE.

Observation:

• A 45-year-old woman presented with symptoms of heart failure, including dyspnea, chest pain, orthopnea, and bilateral leg edema.
• On admission, she exhibited signs of nephrotic syndrome and a global pericardial effusion.
• The pericardial effusion was causing impending cardiac tamponade, necessitating pericardiocentesis.

Findings:

• Clinical and biochemical evaluation confirmed the diagnosis of systemic lupus erythematosus.
• The patient was diagnosed with lupus nephritis, a kidney manifestation of SLE.
• The pericardial effusion was successfully managed with pericardiocentesis.

Implications:

• This case highlights the critical importance of recognizing multi-organ involvement in SLE.
• Prompt diagnosis and management of cardiac and renal complications are vital for patient outcomes.
• Aggressive immunosuppressive therapy and supportive care, including dialysis, are essential for managing severe SLE manifestations.