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表现为心脏压塞的自身免疫性暴发性心肌心包炎——系统性红斑狼疮患者中的罕见病例

Autoimmune fulminant myopericarditis presenting as cardiac tamponade-A rare occurrence in a patient with systemic lupus erythematosus.

作者信息

Wasir Amanpreet Singh, Darak Anuj, Doad Jagroop, Bharadwaj Prashant, Kalra Ravi

机构信息

Bharati Vidyapeeth (Deemed to be University) Medical College, Pune, Maharashtra, India.

Department of Cardiology, Bharati Vidyapeeth (Deemed to be University) Medical College, Pune, Maharashtra, India.

出版信息

JRSM Cardiovasc Dis. 2025 Aug 11;14:20480040251368556. doi: 10.1177/20480040251368556. eCollection 2025 Jan-Dec.

Abstract

Cardiac tamponade is a rare, life-threatening condition caused by accumulation of pericardial fluid, leading to rapid changes in hemodynamic status. Common causes include cancer, chest trauma, pericarditis, autoimmune diseases, and infectious agents such as viruses, bacteria, and fungi. Patients typically present with symptoms of weakness, chest pain, and shortness of breath. We present the case of a young female who presented with obstructive shock and echocardiographic evidence of tamponade. She was worked up and found to have cardiogenic shock likely secondary to systemic lupus erythematosus and fulminant myopericarditis. Prompt intervention with pericardiocentesis of 250 mL of exudative fluid led to significant improvement in left ventricle function and hemodynamic stability. The case highlights the importance for early recognition and a broad differential diagnosis-including autoimmune causes-when evaluating potential tamponade.

摘要

心脏压塞是一种罕见的、危及生命的疾病,由心包积液积聚引起,导致血流动力学状态迅速变化。常见病因包括癌症、胸部创伤、心包炎、自身免疫性疾病以及病毒、细菌和真菌等感染因子。患者通常表现为虚弱、胸痛和呼吸急促等症状。我们报告一例年轻女性病例,该患者表现为梗阻性休克且有心脏压塞的超声心动图证据。对其进行检查后发现可能继发于系统性红斑狼疮和暴发性心肌心包炎的心源性休克。立即进行心包穿刺抽出250毫升渗出液,使左心室功能和血流动力学稳定性得到显著改善。该病例凸显了在评估潜在心脏压塞时早期识别以及进行广泛鉴别诊断(包括自身免疫性病因)的重要性。

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