Peripartum Unmasking of Acute Lupus Myopericarditis.

BACKGROUND

There is a broad differential diagnosis that should be considered when assessing a postpartum patient in cardiopulmonary distress.

CASE

The authors present a case of postpartum systemic lupus erythematosus (SLE)-associated myopericarditis causing heart failure with reduced ejection fraction highlighting the challenges of diagnosis and treatment of new-onset heart failure in postpartum patients.

DISCUSSION

A unique element of this case was peripartum unmasking of SLE with cardiac involvement. Hormonal changes during pregnancy exacerbate helper T-cell mediated autoimmune diseases, potentially triggering SLE in this patient.

TAKE-HOME MESSAGE: This case emphasizes the importance of using cardiac magnetic resonance imaging to determine the etiology of heart failure during the postpartum period and shared decision-making around guideline-directed medical therapy in a lactating patient.