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Hypertrophic Cardiomyopathy Requiring Myectomy in a Young Patient With Systemic Lupus Erythematosus: A Case Report
Wael Abdelmottaleb1, Donclair Brown2, Mustafa Ozbay1
1Internal Medicine, New York Medical College/Metropolitan Hospital Center, New York, USA.
Insights
Systemic lupus erythematosus (SLE) can affect the heart, leading to hypertrophic cardiomyopathy (HCM). This case highlights a patient with SLE and end-stage renal disease who developed hypertrophic obstructive cardiomyopathy (HOCM).
Area of Science:
- Cardiology
- Rheumatology
- Nephrology
Background:
- Systemic lupus erythematosus (SLE) is a multi-organ autoimmune disease.
- Cardiac involvement is common in SLE, affecting various heart structures.
- Hypertrophic cardiomyopathy (HCM) is a primary myocardial disease, often genetic.
Abstract:
Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect multiple organ systems. Among these, the heart, including the pericardium, conduction system, myocardium, valves, and coronary arteries, can be affected. Hypertrophic cardiomyopathy (HCM) is a myocardial disease caused mainly by genetic mutation. The association between SLE and HCM is still unclear. We are reporting a case of a 25-year-old female with SLE with end-stage renal disease (ESRD) due to lupus nephritis, who was found to have hypertrophic obstructive cardiomyopathy (HOCM) on the echocardiogram and required septal myectomy. She presented to the hospital with dyspnea and was admitted as a hypertensive emergency with pulmonary edema, which required intubation and admission to the cardiac intensive care unit (CICU). She underwent urgent hemodialysis and blood pressure medication adjustment and then improved and was discharged home. Based on the literature review, 10 cases of SLE and HCM were reported, and the underlying mechanisms linking SLE and HCM remain unclear. Further studies are warranted for a better understanding of the association between SLE and HCM.
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