J Korean Rheum Assoc.  2007 Sep;14(3):302-306. 10.4078/jkra.2007.14.3.302.

Systemic Lupus Erythematosus Presenting as Acute Lupus Myocarditis

• Kang JI
• Kim SH

• KMID: 2202183
• DOI: http://doi.org/10.4078/jkra.2007.14.3.302

Abstract

Systemic lupus erythematous (SLE) is an autoimmune inflammatory disease of unknown etiology which affects various parts of body. SLE can involve all parts of the heart including the pericardium, myocardium, endocardium, heart valves and coronary arteries. Cardiopathy of SLE is the third common cause of death in all patients with SLE. Although cardiopulmonary symptoms are common in SLE, symptomatic acute lupus myocarditis is a very rare and fatal complication of SLE. We report here on a 20-year-old female patient with acute myocarditis as a initial manifestation of SLE and rapidly diagnosed using echocardiogram.

Keyword

Acute lupus myocarditis; Systemic lupus erythematosus; Echocardiogram

MeSH Terms

Cause of Death
Coronary Vessels
Endocardium
Female
Heart
Heart Valves
Humans
Lupus Erythematosus, Systemic*
Myocarditis*
Myocardium
Pericardium
Young Adult

Figure

• 

  Fig. 1. Chest x-ray shows cardiomegaly (CT ratio 0.55). No pulmonary edema and pleural effusion are noted.

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  Fig. 2. Electrocardiography shows regular rhythm and biphasic T wave in V2~4 and T-wave inversion in leads V5~6.

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  Fig. 3. Transthoracic echocardiography (M-mode echocardiography) shows a borderline left ventricular end-diastolic dimension (LVEDD) dilatation, decreased ejection fraction (32%) and minimal pericardial effusion.

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  Fig. 4. Myocardial SPECT shows reversible perfusion defect on anterior wall.

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  Fig. 5. Follow-up transthoracic echocardiography shows decreased left ventricular end-diastolic dimension (LVEDD) (48 mm) than before (52 mm) and improved ejection fraction (56%) than before (32%) and no pericardial effusion.

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