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Left ventricular aneurysm, normal coronary arteries and embolization in a patient with systemic lupus erythematosus
H Nagaoka1, N Funakoshi, R Innami
1Department of Cardiovascular and Thoracic Surgery, Tsuchiura Kyodo General Hospital, Japan.
Insights
Systemic lupus erythematosus (SLE) can cause myocardial infarction and systemic embolism, even with normal coronary arteries. This case highlights a rare presentation and successful surgical treatment in a young woman.
Area of Science:
- Cardiology
- Rheumatology
- Vascular Surgery
Background:
- Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect multiple organ systems, including the cardiovascular system.
- Myocardial infarction (MI) in young adults is uncommon, and its association with SLE and normal coronary arteries is particularly rare.
- Systemic embolism is a serious complication that can arise from cardiac events.
Observation:
- A 30-year-old woman with SLE presented with myocardial infarction (MI).
- Despite having a normal coronary artery appearance, she developed a left ventricular aneurysm.
- The patient experienced significant systemic embolization, including cerebral infarctions and a saddle embolism.
Findings:
- This case represents the first reported instance of systemic embolism secondary to myocardial infarction in a patient with SLE who had a normal coronary artery.
- The patient underwent surgical treatment for the cardiac and embolic complications.
- The surgical intervention resulted in a favorable outcome.
Implications:
- This case underscores the potential for severe cardiovascular manifestations of SLE, even in the absence of typical coronary artery disease.
- It highlights the importance of considering SLE in young patients presenting with MI and embolic events.
- Surgical management may be a viable option for complex cardiac complications in SLE patients.
Abstract:
We describe a 30-year-old woman with a normal appearing coronary artery associated with SLE who suffered myocardial infarction with left ventricular aneurysm and systemic embolization including cerebral infarctions and saddle embolism. The patient was surgically treated with good results. To our knowledge this is the first reported case of systemic embolism due to myocardial infarction occurring in SLE with a normal coronary artery.