title: Acute lupus myocarditis: Clinical features and outcome.
abstract: BACKGROUND
  Cardiomyopathy in systemic lupus erythematosus (SLE) may be secondary to myocardial inflammation (i.e. myocarditis) or to systemic complications such as hypertension. Symptomatic left ventricular dysfunction is the most common clinical presentation of cardiomyopathy and is potentially life threatening. Identifying the cause is critical as it dictates therapy.
  
  
  METHODS
  We present three cases of left ventricular failure suggestive of myocarditis in SLE patients followed in the Lupus Clinic of the Montreal General Hospital over a 5-year period.
  
  
  RESULTS
  The most frequent presentation is acute onset of a marked reduction of the left ventricular ejection fraction (LVEF). All patients were treated with cardiac support, prednisone, and additional immunosuppressive medications. Improvement of symptoms and LVEF was observed in two of three patients.
  
  
  CONCLUSIONS
  Myocarditis is a rare, but life-threatening, manifestation of SLE. With immunosuppressive medications and cardiovascular support, the long-term outcome is usually favorable.
authors.affiliation: Divisions of Clinical Immunology/Allergy and Clinical Epidemiology, McGill University Health Centre, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Appenzeller
authors.forename: C A
authors.initials: CA
authors.lastname: Pineau
authors.forename: A E
authors.initials: AE
authors.lastname: Clarke
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000150:complications / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology*; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000503:physiopathology
chemical_list: D007166:Immunosuppressive Agents