J Korean Med Sci.  2009 Feb;24(1):176-178. 10.3346/jkms.2009.24.1.176.

Lupus Myocarditis Presenting as Acute Congestive Heart Failure: A Case Report

• Woo SI
• Hwang GS
• Kang SJ
• Park JS
• Park SJ
• Lee YS
• Lee YH
• Tahk SJ

• KMID: 1794429
• DOI: http://doi.org/10.3346/jkms.2009.24.1.176

Abstract

A young woman who had a delivery history 3 months previously presented with dyspnea and orthopnea. Initial findings of physical examination, chest radiography, and echocardiogram showed typical congestive heart failure with severe left ventricular (LV) dysfunction. At first, we considered peripartum cardiomyopathy because she had given birth to a baby 3 months previously. However, even though we massively tried conventional drug therapy for 10 days, the patient still remained with refractory heart failure. We performed additional laboratory studies such as complement level and autoantibodies, of which the results supported systemic lupus erythematosus. We could make the diagnosis of acute lupus myocarditis and treated her with corticosteroid. The symptoms were dramatically disappeared and LV function also improved.

Keyword

Lupus Erythematosus, Systemic; Lupus Myocarditis

MeSH Terms

Acute Disease
Administration, Oral
Adult
Echocardiography
Female
Glucocorticoids/administration & dosage
Heart Failure/*diagnosis
Humans
Lupus Erythematosus, Systemic/complications/*diagnosis/radiography
Methylprednisolone/administration & dosage
Myocarditis/*diagnosis/etiology/radiography
Prednisolone/administration & dosage

Figure

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  Fig. 1 Chest radiography in time sequence A through D. (A) showed cardiomegaly, interstitial pulmonary edema and pleural effusion on admission. (B) showed interstitial pulmonary edema and pleural effusion were still remained after intensive customary heart failure therapy for 10 days. Pulmonary edema and pleural effusion were dramatically decreased in 48 hr (C) and disappeared in 2 weeks (D) after corticosteroid therapy.

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  Fig. 2 Two-dimensional echocardiography on admission (A) and 2 weeks after corticosteroid therapy (B). Left ventricular function was much improved with corticosteroid therapy. LVEF, left ventricular ejection fraction; LVEDD, left ventricular end-diastolic dimension; LVESD, left ventricular end-systolic dimension.

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