A rare case of acute myocardial infarction with a non-specific symptom in a young female with systemic lupus erythematosus

Abstract

A 31-year-old female with an 18-year history of systemic lupus erythematosus (SLE) complained of epigastralgia and consulted the emergency outpatient department at our hospital. Her physical examination revealed tenderness at the scrobiculus cordis, which was a non-specific symptom of coronary heart disease (CHD). We ultimately gave a diagnosis of acute myocardial infarction based on coronary angiography and performed percutaneous coronary intervention. Although pre-interventional intravascular ultrasound demonstrated distinct atherosclerotic lesions in the coronary arteries, there were no atherosclerotic lesions in other systemic arteries. Although CHD in young SLE patients is a significant cause of morbidity and premature death, it tends to be misdiagnosed because their symptoms may be non-specific. In addition, this case highlights the fact that even SLE patients with no systemic atherosclerosis are at risk for the development of CHD.<Learning objective: Coronary heart disease (CHD) in young systemic lupus erythematosus (SLE) patients is a significant cause of morbidity and premature death, but it tends to be misdiagnosed because their symptoms may be non-specific. Moreover, SLE patients are at risk for the development of CHD.>