Perimyocarditis With Acute Heart Failure as the First Manifestation of Systemic Lupus Erythematosus

Area of Science:

• Cardiology
• Rheumatology
• Internal Medicine

Background:

• Cardiac abnormalities are frequent in Systemic Lupus Erythematosus (SLE).
• Non-invasive imaging like echocardiography and cardiac MRI often detect mild or asymptomatic cardiac involvement.
• Heart failure due to perimyocarditis as an initial SLE presentation is exceptionally rare.

Observation:

• A case study of an adult female presenting with acute dyspnea, chest pain, and lower limb edema.
• Initial chest X-ray revealed cardiomegaly and bilateral lung opacities.
• Electrocardiogram showed sinus tachycardia and non-specific T-wave changes.

Findings:

• Elevated cardiac biomarkers indicated acute myocardial injury.
• Specific antibodies for SLE were positive.
• The patient's symptoms were attributed to perimyocarditis as the initial manifestation of SLE.

Implications:

• This case underscores the importance of considering SLE in patients presenting with unexplained heart failure, even without typical lupus symptoms.
• Early recognition and diagnosis of perimyocarditis in SLE are crucial for timely intervention and management.
• Highlights the diagnostic challenge of SLE presenting initially with severe cardiac involvement.