title: Rare Presentation of Lupus Myocarditis With Acute Heart Failure-A Case Report.
abstract: Systemic lupus erythematosus is an autoimmune disease with diffuse organ involvement. The cardiac complications include pericarditis, myocarditis, pulmonary hypertension, coronary vasculitis, and Libman-Sacks endocarditis. Symptomatic lupus myocarditis presenting with left ventricular dysfunction, acute heart failure, and pulmonary edema, although rare, is a life-threatening complication. We report the occurrence of acute lupus myocarditis in a 38-year-old postpartum female who had a cesarean section a week before presentation for preeclampsia. Initially she was managed for pneumonia but later found to have acute pericarditis and myocarditis related to systemic lupus erythematosus. She had a complicated hospital course including acute respiratory failure and cardiogenic shock. She was started on pulse dose steroids besides the treatment for heart failure and had a dramatic improvement within days.
authors.affiliation: Departments of 1Internal Medicine; 2Rheumatology; 3Cardiology; 4Pulmonary and Critical Care Medicine; and 5Family Medicine, Mt Sinai Hospital, Chicago, IL.
authors.forename: Gurveen
authors.initials: G
authors.lastname: Malhotra
authors.forename: Serafin
authors.initials: S
authors.lastname: Chua
authors.forename: Vamsi
authors.initials: V
authors.lastname: Kodumuri
authors.forename: Sivashankar
authors.initials: S
authors.lastname: Sivaraman
authors.forename: Priya
authors.initials: P
authors.lastname: Ramdass
mesh_terms: D000208:Acute Disease; D000328:Adult; D002585:Cesarean Section; D003428:Cross Infection / Q000150:complications; D004452:Echocardiography; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000188:drug therapy; D008775:Methylprednisolone / Q000627:therapeutic use; D009205:Myocarditis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D009206:Myocardium / Q000473:pathology; D010490:Pericardial Effusion / Q000000981:diagnostic imaging / Q000209:etiology*; D011014:Pneumonia / Q000150:complications; D011225:Pre-Eclampsia; D011247:Pregnancy; D011654:Pulmonary Edema / Q000209:etiology*; D012131:Respiratory Insufficiency / Q000209:etiology*; D012770:Shock, Cardiogenic / Q000209:etiology*
chemical_list: D005938:Glucocorticoids; D008775:Methylprednisolone