Malhotra Gurveen, Chua Serafin, Kodumuri Vamsi, Sivaraman Sivashankar, Ramdass Priya
Departments of 1Internal Medicine; 2Rheumatology; 3Cardiology; 4Pulmonary and Critical Care Medicine; and 5Family Medicine, Mt Sinai Hospital, Chicago, IL.
Am J Ther. 2016 Nov/Dec;23(6):e1952-e1955. doi: 10.1097/MJT.0000000000000295.
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.
系统性红斑狼疮是一种累及多器官的自身免疫性疾病。心脏并发症包括心包炎、心肌炎、肺动脉高压、冠状动脉血管炎和Libman-Sacks心内膜炎。有症状的狼疮性心肌炎表现为左心室功能障碍、急性心力衰竭和肺水肿，虽然罕见，但却是一种危及生命的并发症。我们报告了一例38岁产后女性发生急性狼疮性心肌炎的病例，该患者在因先兆子痫就诊前一周行剖宫产术。最初她因肺炎接受治疗，但后来发现患有与系统性红斑狼疮相关的急性心包炎和心肌炎。她的住院过程复杂，包括急性呼吸衰竭和心源性休克。除了心力衰竭治疗外，她开始接受大剂量脉冲类固醇治疗，并在数天内有显著改善。
