Case Session 05: Systemic and Inflammatory Disease (2018)-Imaging of acute myocarditis in patient with systemic lupus erythematosus

Imaging of acute myocarditis in patient with systemic lupus erythematosus

Video Transcription

Video Summary

This presentation described acute lupus myocarditis in a 26-year-old woman with systemic lupus erythematosus who developed chest pain, diffuse ST elevation, and elevated troponin. Coronary arteries were normal. Conventional echocardiography showed only mild dysfunction, but speckle-tracking strain revealed markedly impaired global longitudinal strain. Cardiac MRI confirmed myocarditis with edema and extensive late gadolinium enhancement, and biopsy proved immune-complex myocarditis. High-dose steroids improved symptoms, but relapse occurred after tapering, requiring renewed steroids and biologic therapy. At six months, symptoms, strain, ejection fraction, and MRI findings improved significantly.

Keywords

acute lupus myocarditis

systemic lupus erythematosus

global longitudinal strain

cardiac MRI

immune-complex myocarditis