Acute myocarditis and left ventricular aneurysm as presentations of systemic lupus erythematosus

Chest. 1996 Jan;109(1):282-4. doi: 10.1378/chest.109.1.282.


A case of systemic lupus erythematosus (SLE) associated with fever, heart failure, and left ventricular (LV) aneurysm is reported. A diagnosis of SLE was suspected owing to the presence of active lymphocytic myocarditis and fibrinous endocarditis at LV endomyocardial biopsy and was confirmed by identification of 4 of the 11 criteria proposed by the American Rheumatism Association for the definition of SLE. A 2-month period of steroid therapy was followed by a remarkable recovery of LV function and progression of endomyocarditis to a healed phase at control LV biopsy. The LV aneurysm disappeared, likely because thrombosis occurred as a result of the hypercoagulable state accompanying the presence of anticardiolipin antibodies. This is the first reported case of LV aneurysm induced by SLE and is a rare clinicohistologic documentation of the effectiveness of steroid treatment on lupus endomyocarditis.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Adult
  • Anti-Inflammatory Agents / therapeutic use
  • Cardiac Output, Low / etiology
  • Diuretics / therapeutic use
  • Endocarditis / etiology
  • Fever
  • Furosemide / therapeutic use
  • Heart Aneurysm / drug therapy
  • Heart Aneurysm / etiology*
  • Heart Ventricles
  • Humans
  • Lupus Erythematosus, Systemic / complications*
  • Lupus Erythematosus, Systemic / drug therapy
  • Male
  • Myocarditis / drug therapy
  • Myocarditis / etiology*
  • Prednisone / therapeutic use
  • Spironolactone / therapeutic use


  • Anti-Inflammatory Agents
  • Diuretics
  • Spironolactone
  • Furosemide
  • Prednisone