Pericarditis is the most commonly recognized cardiac complication in systemic lupus erythematosus (SLE). However, myocarditis with cardiac shock as the initial manifestation of SLE is uncommon. We describe a case of a 28-year-old man who presented cardiogenic shock revealing SLE. A 28-year-old man, white, with a history of smoking, presented to the emergency department in December 2016 with dyspnea. Blood pressure was 165/75 mm Hg, pulse rate 113 beats per minute, body temperature 36°C, and oxygen saturation 100%. Cardiovascular examination was remarkable for signs of congestion with edemas of lower limbs. Skin examination revealed livedo on both feet (Figure 1). Initial laboratory data on admission showed the following: Troponin I 0.053 μg/L (N<0.034 μg/L), brain natriuretic peptide 3342 pg/mL (N<100 pg/mL), aspartate transaminases 2334 IU/L (N<34 IU/L) and alanine transaminases 1120 IU/L (N<55 IU/L), white blood cell count 3700/mm3, hemoglobin 10.4 g/dL, platelet count 206 000/mm3, serum creatinine 84.9 μmol/L. Urine dipstick was negative for protein and blood. The ECG showed sinus tachycardia, negative T wave in V4 through V6 leads, and incomplete right bundle branch block. The chest radiograph revealed cardiomegaly. Echocardiography demonstrated a dilated cardiomyopathy and a biventricular edema, with a left ventricle ejection fraction evaluated at 15% to 20% without pericardial effusion and no significant valvulopathy. Two days …

中文翻译：

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心脏电击揭示系统性红斑狼疮

心包炎是系统性红斑狼疮（SLE）中最常见的心脏并发症。但是，以心律失常为SLE最初表现的心肌炎并不常见。我们描述了一个出现心源性休克揭示SLE的28岁男子的病例。一名有吸烟史的28岁白人白人于2016年12月因呼吸困难向急诊科就诊。血压为165/75 mm Hg，脉搏率为每分钟113次，体温为36°C，血氧饱和度为100％。心血管检查显着发现下肢浮肿的充血迹象。皮肤检查发现双脚有活斑（图1）。入院时的初步实验室数据显示：肌钙蛋白I 0.053μg/ L（N <0.034μg/ L），脑利钠肽3342 pg / mL（N <100 pg / mL），天冬氨酸转氨酶2334 IU / L（N <34 IU / L）和丙氨酸转氨酶1120 IU / L（N <55 IU / L），白细胞计数3700 / mm3，血红蛋白10.4 g / dL，血小板计数206 000 / mm3 ，血清肌酐为84.9μmol/ L。尿试纸中的蛋白质和血液均为阴性。心电图显示窦性心动过速，V4到V6导联的V4负T波和不完全的右束支传导阻滞。胸部X光片显示心脏肥大。超声心动图显示扩张型心肌病和双室水肿，左心室射血分数评估为15％至20％，无心包积液且无明显瓣膜病。两天…… 尿试纸中的蛋白质和血液均为阴性。心电图显示窦性心动过速，V4到V6导联的V4负T波和不完全的右束支传导阻滞。胸部X光片显示心脏肥大。超声心动图显示扩张型心肌病和双室水肿，左心室射血分数评估为15％至20％，无心包积液且无明显瓣膜病。两天…… 尿试纸中的蛋白质和血液为阴性。心电图显示窦性心动过速，V4到V6导联的V4负T波和不完全的右束支传导阻滞。胸部X光片显示心脏肥大。超声心动图显示扩张型心肌病和双室水肿，左心室射血分数评估为15％至20％，无心包积液且无明显瓣膜病。两天……