Internal Medicine Residency Program, University of Chicago, Chicago, Illinois, USA.
Can J Cardiol. 2013 Oct;29(10):1330.e5-1330.e7. doi: 10.1016/j.cjca.2013.05.004. Epub 2013 Aug 2.
We describe a 59-year-old woman with cardiac conduction abnormalities caused by lupus-induced myocardial damage. She had a history of arthralgias and antinuclear antibodies but no clinical history of systemic lupus erythematosus. She presented with syncope and Mobitz type II second-degree atrioventricular block. Anti-double-stranded DNA antibodies developed coincident with the identification of heart block. Cardiac magnetic resonance imaging showed late enhancing foci of gadolinium uptake that anatomically correlated with her conduction abnormalities. We conclude that her conduction disease represents an early and structural cardiac manifestation of systemic lupus erythematosus that is unusual in its presentation at the time of initial diagnosis.
我们描述了一位 59 岁女性，因狼疮导致心肌损伤引起心脏传导异常。她有关节痛和抗核抗体病史，但无系统性红斑狼疮的临床病史。她表现为晕厥和莫氏Ⅱ型二度房室传导阻滞。抗双链 DNA 抗体的出现与心脏阻滞的发现同时发生。心脏磁共振成像显示钆摄取的晚期增强灶，与她的传导异常在解剖学上相关。我们得出结论，她的传导疾病代表系统性红斑狼疮的早期和结构性心脏表现，在初始诊断时的表现不常见。
