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Case Reports
. 2022 Nov 22;6(12):ytac446.
doi: 10.1093/ehjcr/ytac446. eCollection 2022 Dec.

A case report of acute heart failure and cardiogenic shock caused by catastrophic antiphospholipid syndrome and lupus myocarditis

Ashton C Lai  1 , Jason Feinman  1 , Connor Oates  1 , Aditya Parikh  1
Affiliations
Case Reports

A case report of acute heart failure and cardiogenic shock caused by catastrophic antiphospholipid syndrome and lupus myocarditis

Ashton C Lai et al. Eur Heart J Case Rep. .

Abstract

Background: Catastrophic antiphospholipid syndrome and lupus myocarditis are two rare life-threatening conditions.

Case summary: We present a case of a 47-year-old woman admitted in profound cardiogenic shock due to catastrophic antiphospholipid syndrome and lupus myocarditis requiring advanced heart failure therapies, including early mechanical circulatory support. She improved with steroids, immunoglobulins, mycophenolate, and eculizumab.

Discussion: This case highlights the importance of early identification of cardiogenic shock secondary to catastrophic antiphospholipid syndrome and lupus myocarditis, the arrhythmogenic complications of myocarditis, and the subsequent management of the disease progression with mechanical and medical support.

Keywords: Antiphospholipid syndrome; Cardiogenic shock; Case report; Mechanical circulatory support; Myocarditis; Systemic lupus erythematosus; Torsades de Pointes.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Normal coronaries on left heart catheterization. LM, left main coronary artery; LAD, left anterior descending coronary artery; LCx, left circumflex coronary artery; LAO, left anterior oblique; RCA, right coronary artery.
Figure 2
Figure 2
Electrocardiogram on admission to our hospital demonstrating sinus rhythm with a left bundle branch block morphology.
Figure 3
Figure 3
Purpuric lesions with bullae on physical examination.
Figure 4
Figure 4
PVC-triggered Torsades de Pointes.
See this image and copyright information in PMC

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