A thirty-three year-old woman with systemic lupus erythematosus (SLE) suffered from acute myocardial infarction. Prednisolone 20 mg/day was used because the signs of SLE, such as fever and decreased serum C3, levels, became aggravated on the fifth hospital day of acute myocardial infarction. Fatal cardiac rupture occurred on the twenty-second hospital day. At autopsy, extensive myocardial infarction with coronary artery thrombi and diffuse coronary arteritis were revealed. The rare clinical picture of a fatal cardiac rupture in the later phase of acute myocardial infarction and the precise dosage of prednisolone for her SLE are described.
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References
1.
Dubois EL, Wierzchoviecki M., Cox MB, et al: Duration and death in systemic lupus erythematosus. An analysis of 249 cases. JAMA227:1399-1402, 1974 .
2.
Urowitz MB, Bookman Aam, Koehler BE, et al: The bimodal mortality pattern of systemic lupus erythematosus . Am J Med60:221-225, 1976.
3.
Bulkley BH, Roberts WC: The heart in systemic lupus erythematosus and the changes induced in it by corticosteroid therapy. A study of 36 necropsy patients. Am J Med58:243-264, 1975.
4.
Doherty NE, Siegel RJ: Cardiovascular manifestations of systemic lupus erythematosus. Am Heart J110:1257-1265, 1985 .
5.
Cunningham MJ , Rothenberg PL, Schatten S., et al: Infected acute myocardial infarct with rupture in systemic lupus erythematosus. Am J Cardiol59:488-489, 1987.
6.
Bulkley BH, Roberts WC: Steroid therapy during acute myocardial infarction. A case of delayed healing and of ventricular aneurysm. Am J Med56:244-248, 1974.
7.
Homcy CJ, Liberthson RR, Fallon JT, et al: Ischemic heart disease in systemic lupus erythematosus in the young patient: Report of six cases. Am J Cardiol49:478-484, 1982.
8.
Badui E., Garcia-Rubi D., Robles E., et al: Cardiovascular manifestations in systemic lupus erythematosus; prospective study of 100 patients. Angiology36:431-441, 1985.
9.
Meller J., Conde CA, Deppisch LM, et al: Myocardial infarction due to coronary atherosclerosis in three young adults with systemic lupus erythematosus. Am J Cardiol35:309-314, 1975.
10.
Fukumoto S. Tsumagari T, Kinjo M., et al: Coronary atherosclerosis in patients with systemic lupus erythematosus at autopsy. Acta Pathol Jpn37:1-9, 1987.
11.
Korbet SM, Schwartz MM, Lewis EJ: Immune complex deposition and coronary vasculitis in systemic lupus erythematous; report of two cases. Am J Med77:141-146, 1984.
