Peripartum Unmasking of Acute Lupus Myopericarditis

There is a broad differential diagnosis that should be considered when assessing a postpartum patient in cardiopulmonary distress.

The authors present a case of postpartum systemic lupus erythematosus (SLE)-associated myopericarditis causing heart failure with reduced ejection fraction highlighting the challenges of diagnosis and treatment of new-onset heart failure in postpartum patients.

A unique element of this case was peripartum unmasking of SLE with cardiac involvement. Hormonal changes during pregnancy exacerbate helper T-cell mediated autoimmune diseases, potentially triggering SLE in this patient.

This case emphasizes the importance of using cardiac magnetic resonance imaging to determine the etiology of heart failure during the postpartum period and shared decision-making around guideline-directed medical therapy in a lactating patient.