lupus erythematosus with and massive infarction Systemic coronary vasculitis myocardial A case report

Summary A 32-year-old white woman presented with angina pectoris and an acute myocardial infarction (MI) complicated by congestive cardiac failure. Other symptoms and results of immunological investigation were highly suggestive of systemic lupus erythema­ tosus (SLE). Thallium-201 scintigraphy confirmed an extensive MI, as initially suspected from an ECG. Cardiac catheterization delineated a poorly con­ tracting left ventricle secondary to MI. Selective coro­ nary angiography showed features suspicious of coronary arteritis involving the left anterior des­ cendingand left circumflex coronary arteries. Right ventricular endomyocardial biopsy failed to show any 'small·vessel disease', vasculitis or myocarditis. We suggest that the acute MJ was caused by coronary arteritis due to SLE. Overview of the litera­ ture indicates that coronary arteritis is not as rare a complicatiqp of SLE as previously believed; however, acute MHs most unusual. SAfr MedJ 1986; 69: 765-768.