Myocardial Infarction and Pulmonary Arterial Hypertension in a Young Patient with Systemic Lupus Erythematosus

Abstract

Systemic Lupus Erythematosus (SLE) is an autoimmune collagen vascular disease, which produces widespread damage to multiple organs. The spectrum of cardiac vascular involvement in young SLE is not elucidated completely. This report mainly describes a 27 year old girl with 20 year history of SLE presenting with both AMI (acute myocardial infarction) and PAH. Coronary angiography shows stenosis in LAD (left anterior descending artery), and occlusion in LCX (left circumflex artery). The right heart catheterization showed elevated pulmonary artery pressure (93/32/57 mmHg); acute vasoreactivity testing was negative to adenosine. Prothrombotic conditions such as homocysteine, anti-cardiolipin antibody, lupus anticoagulant levels were all normal. This is the first case that CAD and PAH happened together in one lupus patient in literature reported.