Lupus carditis

Manifestação rara de edema agudo de pulmão associado à miocardite lúpica aguda

“…The presence of chest pain and tachycardia sustained disproportionately to the presence of fever may occur as reported 5 . On the other hand, clinical signs and symptoms of heart failure as in our case are unusual, being present in only 5% to 10% of patients [1][2][3]5 . There are enormous difficulties in the diagnosis of myocarditis mainly due to the presence of other factors potentially responsible for myocardial damage, such as anemia, hypertension, infection and fluid retention secondary to renal disease or use of corticoids 1 .…”

“…On the other hand, clinical signs and symptoms of heart failure as in our case are unusual, being present in only 5% to 10% of patients [1][2][3]5 . There are enormous difficulties in the diagnosis of myocarditis mainly due to the presence of other factors potentially responsible for myocardial damage, such as anemia, hypertension, infection and fluid retention secondary to renal disease or use of corticoids 1 . In addition, cardiomyopathy in patients with SLE may have different causes such as myocardial ischemia (caused by coronary arteritis, early atherosclerosis, thrombosis or embolism) and secondary to mitral or aortic failure 2 .…”

“…The aggression by autoimmune disease may occur as pericarditis, myocarditis, Libman-Sacks endocarditis, pulmonary arterial hypertension and coronary artery disease and it should be quickly recognized for establishing adequate immunosuppression therapy with specific cardiologic therapy. Early treatment may contribute to reducing mortality and morbidity of the disease, so that the heart disease in SLE is considered the third leading cause of death, behind nephropathy and infections 1 . Currently the chronic use of corticosteroids associated with chronic inflammation of the disease itself can cause premature atherosclerosis, leading to more cases of myocardial ischemia in this group of patients 1 .…”

Cardiogenic Shock as the Initial Presentation of Systemic Lupus Erythematosus: A Case Report and Review of the Literature

“…Initial laboratory findings may be nonspecific, but included in the diagnostic criteria for SLE, 26–28 such as worsening renal function, anemia, and thrombocytopenia. Serum markers of cardiac injury may be elevated, mimicking an acute myocardial infarction, stress‐induced cardiomyopathy, or myocarditis 16,22,23 . Chronic inflammatory markers may also be elevated.…”

“…Serum markers of cardiac injury may be elevated, mimicking an acute myocardial infarction, stress-induced cardiomyopathy, or myocarditis. 16,22,23 Chronic inflammatory markers may also be elevated. A complete rheumathologic panel must be ordered if underlying connective tissue disorder is suspected, since recent studies have demonstrated association between specific antibodies and myocarditis.…”