Cardiac Tamponade: An Unusual First Case Presentation of Systemic Lupus Erythematosus
Dghoughi Sarah *
Department of cardiology, Ibn Rochd University Hospital, Casablanca, Morocco.
Jama Dounia
Department of cardiology, Ibn Rochd University Hospital, Casablanca, Morocco.
Charif Hanae
Department of cardiology, Ibn Rochd University Hospital, Casablanca, Morocco.
Mounaouir Karim
Department of cardiology, Ibn Rochd University Hospital, Casablanca, Morocco.
Bouziane Maha
Department of Cardiology, Faculty of Medicine and Pharmacy, Ibn Rochd University Hospital, Casablanca, Hassan II University of Casablanca, Casablanca, Morocco.
Haboub Meryem
Department of Cardiology, Faculty of Medicine and Pharmacy, Ibn Rochd University Hospital, Casablanca, Hassan II University of Casablanca, Casablanca, Morocco.
Bennouna El Ghali
Department of Cardiology, Faculty of Medicine and Pharmacy, Ibn Rochd University Hospital, Casablanca, Hassan II University of Casablanca, Casablanca, Morocco.
Drighil Abdenasser
Department of Cardiology, Faculty of Medicine and Pharmacy, Ibn Rochd University Hospital, Casablanca, Hassan II University of Casablanca, Casablanca, Morocco.
Habbal Rachida
Department of Cardiology, Faculty of Medicine and Pharmacy, Ibn Rochd University Hospital, Casablanca, Hassan II University of Casablanca, Casablanca, Morocco.
*Author to whom correspondence should be addressed.
Abstract
This case is reported for the rarity of cardiac tamponade as a first manifestation of systemic lupus erythematosus (SLE). Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease with worldwide prevalence, affecting almost every organ in the body. A 27-year-old woman presented to our hospital after two months of progressive shortness of breath, generalized edematous syndrome and diffuse, non-migratory arthralgias; the patient's shortness of breath was exacerbated on exertion and associated with a vague sensation of chest tightness. Transthoracic echocardiography revealed a large circumferential pericardial effusion with an echo-free space of 34 mm in apical view and 36 mm in subcoastal view with an oscillating heart and diastolic collapse of the right ventricle and atrium. This case is reported for the rarity of cardiac tamponade as a first manifestation of SLE. Because pericarditis is more common in SLE patients, the low frequency of tamponade may be partially explained by the extensive use of non-steroidal anti-inflammatory medications (NSAIDs) and steroids, which effectively reduce pericardial inflammation. We emphasize the importance of including SLE in the differential diagnosis of patients presenting with cardiovascular symptoms, as cardiac tamponade and pleural effusion are uncommon early presentations of SLE. Early detection and diagnosis are essential for prompt intervention and better patient outcomes.
Keywords: Systemic lupus erythematosus, cardiac tamponade, echocardiography, pericardial effusion