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Cardiac tamponade as an initial presentation for systemic lupus erythematosus
William Li1, Thomas Frohwein2, Kenneth Ong3
1Internal Medicine, SUNY Upstate Medical University, United States.
The American Journal of Emergency Medicine
|May 21, 2017
Summary
Systemic lupus erythematosus (SLE) can rarely cause life-threatening cardiac tamponade. Early recognition and intervention are crucial for patients presenting with relevant symptoms and examination findings.
Area of Science:
- Rheumatology
- Cardiology
- Internal Medicine
Background:
- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse organ involvement.
- Cardiac tamponade is an uncommon but severe SLE manifestation.
Observation:
- A 61-year-old male presented with acute shortness of breath, fever, and body aches.
- Echocardiography revealed a significant pericardial effusion, indicating cardiac tamponade.
- Physical exam showed joint swelling and pulsus paradoxus.
Findings:
- Pericardiocentesis drained 800mL of fluid.
- Laboratory results confirmed SLE with a high ANA titer (1:630) and anti-dsDNA antibodies (256 IU/mL).
Implications:
- This case underscores cardiac tamponade as a rare, critical SLE presentation.
- Clinicians should consider SLE in the differential diagnosis for patients with cardiac tamponade and suggestive findings.
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