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Systemic lupus erythematosus (SLE) is an autoimmune connective tissue disorder with multiple system involvement which commonly affects the cardiovascular system [1]. Any part of the cardiovascular system can be affected including myocardium, pericardium, coronary arteries, endocardium, and conduction system [1,2]. Cardiac involvement, especially pericarditis and pericardial effusion, are prevalent cardiac manifestations in SLE; however, massive pericardial effusion as an initial presentation is unusual [1,2]. In this report we describe a 47-year-old Iranian woman who presented to the emergency department with massive pericardial effusion. The diagnosis of SLE was confirmed during her hospitalization. The patient improved clinically with evidence of decline in the volume of pericardial effusion after treatment with prednisolone, hydroxychloroquine, and mycophenolate mofetil over a 6-month period. Case Presentation ___________________A 47-year-old Iranian woman with a one-year history of hypothyroidism came to the hospital with headache, dry cough, shortness of breath, and fatigue lasting for 2 weeks but no complaints of photosensitivity, skin rash, arthralgia, Case Report Open AccessSystemic lupus erythematosus (SLE) is an autoimmune connective tissue disorder with multiple system involvements which commonly affects the cardiovascular system. Although pericarditis and pericardial effusion are prevalent cardiac manifestations in SLE, massive pericardial effusion as an initial presentation is unusual. We describe a 47-year-old woman who presented to the hospital with headache, dry cough, shortness of breath, and fatigue. According to the clinical, radiologic, echocardiographic and laboratory rheumatologic test findings, SLE was diagnosed and treatment with prednisolone, hydroxychloroquine, and mycophenolate mofetil was initiated. The patient improved clinically, and follow-up echocardiography showed a reduction in the effusion volume compared with previous tests within the preceding 6 months. In patients with cardiopulmonary symptoms, especially when other organ involvement is seen, screening for autoimmune systemic diseases such as SLE should be considered. To achieve rapid recovery and prevent life-threatening complications, early diagnosis and treatment are essential.

Background: As a promising revascularization therapy, percutaneous coronary intervention (PCI) is widely used in patients with coronary artery disease. No-reflow and low thrombolysis in myocardial infarction (TIMI) flow are two adverse periprocedural events. Objectives: This study aimed to compare the effectiveness of atorvastatin and rosuvastatin in reducing the no-reflow phenomenon in patients undergoing primary PCI. Methods: Following a randomized control design, 280 eligible patients with no history of MI or ischemic heart disease (IHD) with ST-elevation myocardial infarction (STEMI) who were candidates for coronary angioplasty underwent angioplasty from May 2020 to December 2020. Results: Our results showed that TIMI flow III was significantly higher in the rosuvastatin group, while the no-reflow was not seen in this group (P < 0.001). Also, ST resolution after 90 minutes of PCI was significantly better in the rosuvastatin group. Conclusions: This study demonstrated that using a loading dose of rosuvastatin could reduce the no-reflow phenomenon in patients undergoing primary PCI.