Hypertrophic Cardiomyopathy Requiring Myectomy in a Young Patient With Systemic Lupus Erythematosus: A Case Report

TL;DR

A young woman with lupus and kidney disease developed heart muscle thickening requiring surgery, highlighting a rare and poorly understood connection between lupus and heart disease.

Contribution

This case report adds to the limited literature on the co-occurrence of systemic lupus erythematosus and hypertrophic cardiomyopathy.

Findings

A 25-year-old female with SLE and ESRD was diagnosed with hypertrophic obstructive cardiomyopathy requiring septal myectomy.

Literature review identified only 10 reported cases of SLE and HCM association.

The underlying mechanisms linking SLE and HCM remain unclear and require further investigation.

Abstract

Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect multiple organ systems. Among these, the heart, including the pericardium, conduction system, myocardium, valves, and coronary arteries, can be affected. Hypertrophic cardiomyopathy (HCM) is a myocardial disease caused mainly by genetic mutation. The association between SLE and HCM is still unclear.

We are reporting a case of a 25-year-old female with SLE with end-stage renal disease (ESRD) due to lupus nephritis, who was found to have hypertrophic obstructive cardiomyopathy (HOCM) on the echocardiogram and required septal myectomy. She presented to the hospital with dyspnea and was admitted as a hypertensive emergency with pulmonary edema, which required intubation and admission to the cardiac intensive care unit (CICU). She underwent urgent hemodialysis and blood pressure medication adjustment and then improved and was discharged home.

Based on the literature review, 10 cases of SLE and HCM were reported, and the underlying mechanisms linking SLE and HCM remain unclear. Further studies are warranted for a better understanding of the association between SLE and HCM.

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