Acute myocarditis and left ventricular aneurysm as presentations of systemic lupus erythematosus.
A case of systemic lupus erythematosus (SLE) associated with fever, heart failure, and left ventricular (LV) aneurysm is reported. A diagnosis of SLE was suspected owing to the presence of active lymphocytic myocarditis and fibrinous endocarditis at LV endomyocardial biopsy and was confirmed by identification of 4 of the 11 criteria proposed by the American Rheumatism Association for the definition of SLE. A 2-month period of steroid therapy was followed by a remarkable recovery of LV function and progression of endomyocarditis to a healed phase at control LV biopsy. The LV aneurysm disappeared, likely because thrombosis occurred as a result of the hypercoagulable state accompanying the presence of anticardiolipin antibodies. This is the first reported case of LV aneurysm induced by SLE and is a rare clinicohistologic documentation of the effectiveness of steroid treatment on lupus endomyocarditis.
Department of Cardiology, Catholic University, Rome, Italy.
A
A
Frustaci
N
N
Gentiloni
M
M
Caldarulo
D000208:Acute Disease; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002303:Cardiac Output, Low / Q000209:etiology; D004232:Diuretics / Q000627:therapeutic use; D004696:Endocarditis / Q000209:etiology; D005334:Fever; D005665:Furosemide / Q000627:therapeutic use; D006322:Heart Aneurysm / Q000188:drug therapy / Q000209:etiology*; D006352:Heart Ventricles; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000188:drug therapy; D008297:Male; D009205:Myocarditis / Q000188:drug therapy / Q000209:etiology*; D011241:Prednisone / Q000627:therapeutic use; D013148:Spironolactone / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D004232:Diuretics; D013148:Spironolactone; D005665:Furosemide; D011241:Prednisone