Cardiac Tamponade, an Unusual First Presentation of Systemic Lupus Erythematosus: A Case Report in a Rural Tertiary Hospital

Emorinken, Airenakho; Dic-Ijiewere, Mercy Ofunami; Izirein, Hannah O

doi:10.7759/cureus.27989

Cited by 5 publications

(13 citation statements)

References 17 publications

(29 reference statements)

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“…After pericardiocentesis and steroid medication, pericardiectomy is another option if there is a subsequent buildup of pericardial fluid. This procedure is also useful in averting the development of constrictive pericarditis symptoms in the future [16].…”

Section: Discussionmentioning

confidence: 99%

Cardiac tamponade in a male as an initial presentation of SLE. An interesting case report

Affas¹

2022

J Clin Images Med Case Rep

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A relapsing and remitting illness that may affect any organ system, systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory condition. Autoantibodies and immune complex development are its defining features. The heart is one of the organs that it might impact. In patients with SLE, the immune system’s response to dying cells is aberrant. The diagnosis of SLE is made on the basis of distinctive clinical findings in the skin, joints, kidneys, and central nervous system, as well as serological indicators like antinuclear antibodies (ANA), specifically antibodies to dsDNA. Nonsteroidal anti-inflammatory medicines (NSAIDs), corticosteroids, immunosuppressive medications, and biological agents may be used to treat lupus, depending on the symptoms, findings of blood tests, and the specific organs affected. Here we are reporting a rare case of a male with pericardial tamponade as a first symptom of SLE.

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Section: Discussionmentioning

confidence: 99%

Cardiac tamponade in a male as an initial presentation of SLE. An interesting case report

Affas¹

2022

J Clin Images Med Case Rep

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“…Emorinken et al discussed a case of cardiac tamponade as an unusual first presentation of SLE. Findings, in this case, included the chest radiograph showing an increased cardiac silhouette, an expected result in cardiac tamponade [ 29 ]. Investigations showed a massive proximate pericardial effusion measuring 2.7 cm in the parasternal long-axis view and 2.4 cm in the subcoastal view [ 29 ].…”

Section: Reviewmentioning

confidence: 99%

“…Findings, in this case, included the chest radiograph showing an increased cardiac silhouette, an expected result in cardiac tamponade [ 29 ]. Investigations showed a massive proximate pericardial effusion measuring 2.7 cm in the parasternal long-axis view and 2.4 cm in the subcoastal view [ 29 ]. Additionally, ANAs with a titer of 1:1280 (<1:80), anti-Sm, anti-SSA, and anti-dsDNA antibodies were all positive [ 29 ].…”

Section: Reviewmentioning

confidence: 99%

“…Investigations showed a massive proximate pericardial effusion measuring 2.7 cm in the parasternal long-axis view and 2.4 cm in the subcoastal view [ 29 ]. Additionally, ANAs with a titer of 1:1280 (<1:80), anti-Sm, anti-SSA, and anti-dsDNA antibodies were all positive [ 29 ]. Chourabi et al have reported that when cardiac tamponade is diagnosed with SLE, it often presents as the initial finding in patients with a previously undiagnosed disease [ 30 ].…”

Section: Reviewmentioning

confidence: 99%

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Systemic Lupus Erythematosus and Cardiovascular Diseases: A Systematic Review

Nor¹,

Ogedegbe²,

Barbarawi³

et al. 2023

Cureus

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Systemic lupus erythematosus (SLE) is an autoimmune condition characterized by multi-organ involvement. The clinical presentation often varies from mild to moderate to severe. The cardiovascular system may also be affected, often portending a poor prognosis for patients. Although the relationship between SLE and cardiovascular disorders has been extensively explored through case reports and literature reviews, few systematic reviews explicitly focusing on this association have been conducted. In light of this, this systematic review aims to analyze the extent of the association between SLE and cardiovascular diseases (CVDs), by exploring the risk of developing CVDs, including myocardial infarction (MI), atherosclerosis, myocarditis, pericarditis and arrhythmias, in SLE patients vs. non-SLE patients. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to perform the systematic review. A detailed search was done covering the period from March 2003 to March 2023 using three databases: PubMed, Google Scholar, and Cochrane. The PubMed search identified 597 articles, while Google Scholar and Cochrane searches yielded 559 and three articles, respectively. Of the 1159 articles retrieved, we chose eight for final consideration, after excluding papers that did not discuss the role of SLE in CVDs, papers published earlier than 2003, and papers with incomplete data. The eight studies chosen included two narrative reviews, two systematic reviews, and four observational studies. In this systematic review, SLE was proven to have a strong relationship with diverse CVDs, including rare ones scarcely discussed in the literature, such as vasculitis and aortic dissection. All eight of the final papers indicated a connection between SLE and CVDs, based on the systematic analysis of these articles, which revealed that most recent research supports a higher risk of peripheral arterial occlusive disease (PAOD), MI, pericarditis, myocarditis, and other cardiovascular disorders in individuals with SLE. These associations may have certain gray areas, as patient characteristics and comorbidities often affect the extent of illness and long-term prognosis. Larger-scale studies are required to probe this relationship further and research the etiopathogenesis involved in order to improve patient outcomes. The effects of SLE on the heart are, however, unequivocal.

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“…Inflammation of the pericardium, acute renal failure, and anticoagulant therapy are some of the risk factors associated with the progression of tamponade in patients with SLE [ 5 ]. However, it is most common during acute flares of SLE when the immune system triggers a cascade of reactions to attack various organs, including the heart [ 6 ]. The condition presents with symptoms such as chest pain, shortness of breath, low blood pressure, and rapid heartbeat.…”

Section: Introductionmentioning

confidence: 99%

A 35-Year-Old Female With a Lupus Flare Presenting as Cardiac Tamponade: A Case Report

Bhatt,

Schmidt,

Qasim

et al. 2023

Cureus

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Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder that affects multiple organ systems, significantly impacting the cardiovascular system. One potential complication of acute SLE flare is the development of pericardial effusion which can lead to potentially life-threatening consequences if not promptly identified. In this report, we describe the case of a 35-year-old female with a known history of SLE who developed rapid-onset, large-volume pericardial effusion with tamponade during a lupus flare. She received emergency treatment involving pericardiocentesis and was administered high doses of glucocorticoid and immunosuppressive medication. As a result, the pericardial effusion gradually resolved, and the patient’s symptoms improved. This case emphasizes the significance of immediately identifying and managing swiftly progressing pericardial effusion in SLE patients. This is crucial as it can lead to severe and potentially lethal complications.

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Cardiac Tamponade, an Unusual First Presentation of Systemic Lupus Erythematosus: A Case Report in a Rural Tertiary Hospital

Cited by 5 publications

References 17 publications

Cardiac tamponade in a male as an initial presentation of SLE. An interesting case report

Cardiac tamponade in a male as an initial presentation of SLE. An interesting case report

Systemic Lupus Erythematosus and Cardiovascular Diseases: A Systematic Review

A 35-Year-Old Female With a Lupus Flare Presenting as Cardiac Tamponade: A Case Report

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