The spectrum of lupus myocarditis: from asymptomatic forms to cardiogenic shock

Area of Science:

• Cardiology
• Rheumatology
• Immunology

Background:

• Lupus myocarditis is a rare but life-threatening cardiac manifestation of systemic lupus erythematosus.
• It is frequently misdiagnosed, especially when presenting acutely without a prior lupus diagnosis.
• Current management relies heavily on case reports and clinical expertise due to a lack of randomized controlled trials.

Purpose of the Study:

• To review the diagnostic challenges and clinical presentation of lupus myocarditis.
• To highlight cardiogenic shock as a critical manifestation of this condition.
• To discuss current and emerging management strategies for lupus myocarditis.

Main Methods:

• Literature review of lupus myocarditis, focusing on case reports and clinical experience.
• Analysis of diagnostic criteria and clinical presentations.
• Evaluation of treatment modalities, including immunosuppression and mechanical support.

Main Results:

• Lupus myocarditis can present as acute or fulminant myocarditis, often mimicking other causes.
• Cardiogenic shock is a significant and potentially fatal complication.
• Effective management involves aggressive immunosuppression, mechanical circulatory support, and consideration for cardiac transplantation.

Conclusions:

• Lupus myocarditis requires heightened clinical suspicion, particularly in cases of unexplained acute myocarditis.
• Timely and specific treatment, including immunosuppressive therapy and advanced cardiac support, is crucial for improving outcomes.
• Further research, including randomized controlled trials, is needed to optimize treatment protocols.