A case report of acute heart failure and cardiogenic shock caused by catastrophic antiphospholipid syndrome and lupus myocarditis

Abstract

Background Catastrophic antiphospholipid syndrome and lupus myocarditis are two rare life-threatening conditions. Case Summary We present a case of a 47-year-old woman admitted in profound cardiogenic shock due to catastrophic antiphospholipid syndrome and lupus myocarditis requiring advanced heart failure therapies, including early mechanical circulatory support. She improved with steroids, immunoglobulins, mycophenolate, and eculizumab. Discussion This case highlights the importance of early identification of cardiogenic shock secondary to catastrophic antiphospholipid syndrome and lupus myocarditis, the arrhythmogenic complications of myocarditis, and the subsequent management of the disease progression with mechanical and medical support.

Cardiogenic Shock in Puerperal Patient: Uncommon Immunological Complication a Case Report and Literature Review

“…These episodes of thrombosis can be acute or chronic, and the diagnosis is made through biopsy, which was not performed in our patients. Although the possibility as the etiology cannot be de nitively excluded in our patients, the improvement of some clinical features with the use of immunosuppressants makes this diagnosis less likely (9).…”

“…Cardiac manifestations in catastrophic APS occur in half of the cases and consist mainly of valvulopathy, Libman-Sacks endocarditis, and myocardial infarction. Severe heart failure with cardiogenic shock is even rarer in APS than in SLE (9).…”

Catastrophic antiphospholipid syndrome: challenging case and importance of multidisciplinary evaluation and management

“… 10 After cerebral involvement, cardiac effects of CAPS are noted to be the second most frequent cause of death. 11 Clinical deterioration has been seen in the form of worsening systolic dysfunction, 7 , 8 , 10 , 12 , 13 cardiogenic shock, 7 , 14 cardiac arrest, 12 and need for mechanical support. 12 , 14 …”

“… 11 Clinical deterioration has been seen in the form of worsening systolic dysfunction, 7 , 8 , 10 , 12 , 13 cardiogenic shock, 7 , 14 cardiac arrest, 12 and need for mechanical support. 12 , 14 …”

Catastrophic Antiphospholipid Syndrome: A Rare Cause of Acute Heart Failure

“…In a short time, microvascular thrombosis results in multi-organ failure. Any organ can be affected, including the kidneys, lungs, and heart [ 2 - 5 ]. Treatment includes triple therapy with anticoagulation, corticosteroids, and plasma exchange [ 2 ].…”