A rare case of acute myocardial infarction with a non-specific symptom in a young female with systemic lupus erythematosus

Systemic Lupus Erythematosus Presenting as Cardiac Tamponade and Pleural Effusion: A Case Report

Systemic lupus erythematosus (SLE) is a chronic inflammatory disease that can affect the heart, lungs, and other organs. We describe the case of a 36-year-old female patient who first presented with non-specific symptoms before receiving a diagnosis of SLE, along with initial evidence of pleural effusion and cardiac tamponade. Heart tamponade, which is characterized by fluid accumulation in the pericardial space, is an unusual but serious side effect of SLE. Pleural effusion, or an accumulation of fluid in the pleural cavity, is a typical hallmark of SLE; however, it rarely manifests as the disease's initial symptom. The early identification and diagnosis of these cardiovascular symptoms of SLE is critical for timely intervention and improved patient outcomes. This case report highlights the significance of considering SLE when performing a differential diagnosis for patients who have cardiovascular symptoms, particularly when pleural effusion and cardiac tamponade are present. To increase awareness and knowledge of these uncommon presentations of SLE, more investigations and comprehension of the underlying pathophysiology are required.

Acute Myocardial Infarction as the First Presentation of Systemic Lupus Erythematosus in a 23-Year-Old Patient

ST-segment elevation myocardial infarction (STEMI) in young adults is a rare occurrence that requires a thorough investigation to determine the underlying cause. Herein, a young female patient presented with dull retrosternal chest pain associated with nausea and left arm numbness. Cardiac-specific troponin was elevated and the electrocardiogram revealed ST-segment elevation in the inferior wall leads indicative of myocardial infarction. The patient was started on dual antiplatelet therapy (DAPT) and emergency coronary angiography was performed, revealing a 20% stenosis in the left circumflex artery and evidence of a thrombotic lesion in the posterolateral branch (PLB), which was deemed unsuitable for intervention. During the diagnostic workup, the patient tested positive for antinuclear antibodies and was ultimately diagnosed with systemic lupus erythematosus (SLE) and antiphospholipid syndrome. This case highlights the rarity of STEMI as an initial presentation of SLE. It emphasizes the importance of considering autoimmune disorders in young patients with acute myocardial infarction and the need for a comprehensive evaluation and appropriate management in such cases.