Richardson Annie, Kersey Cooper B, Balansay Brianna, Yang Eugene
University of Washington School of Medicine, Seattle, Washington, USA.
Desartment of Medicine, Division of Cardiology, University of Washington School of Medicine, Seattle, Washington, USA.
JACC Case Rep. 2025 Apr 2;30(7):103500. doi: 10.1016/j.jaccas.2025.103500.
There is a broad differential diagnosis that should be considered when assessing a postpartum patient in cardiopulmonary distress.
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.
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.
在评估出现心肺功能不全的产后患者时，需要考虑广泛的鉴别诊断。
作者报告了一例产后系统性红斑狼疮（SLE）相关的心肌心包炎导致射血分数降低的心力衰竭病例，突出了产后新发心力衰竭诊断和治疗的挑战。
该病例的一个独特之处是围产期SLE伴心脏受累被揭示。怀孕期间的激素变化会加剧辅助性T细胞介导的自身免疫性疾病，可能在该患者中引发SLE。
本病例强调了在产后期间使用心脏磁共振成像来确定心力衰竭病因以及在哺乳期患者中围绕指南指导的药物治疗进行共同决策的重要性。
