First Author pada Abstrak “Large Pericardial Effusion Due To Systemic Lupus Erythematosus : Diagnostic and Management Approach”
Ditampilkan sebagai Poster Case Report pada 31st Weekend Course on Cardiology (WECOC) 2019
Large Pericardial Effusion Due To Systemic Lupus Erythematosus : Diagnostic and Management Approach
A. I. Nurudinulloh1, P. R. Indrisia1, H. Priatna2, P. Rahasto2, S. E. Nauli2
1General Practitioner, Tangerang General Hospital
2Department of Cardiology and Vascular Medicine, Tangerang General Hospital
Pericardial effusion is an increased production of pericardial fluid, blood, pus, clots or gas in pericardial cavity, and massively, it will disrupt cardiac contractility and further worsening cardiac output and can be life-threatening. Pericardial effusion is one of cardiovascular complications that occurs in patients with Systemic Lupus Erythematosus (SLE) due to its autoimmune reaction and inflammation.
A 25 years old woman came to Emergency Department complaining shortness of breath worsening since two days before admission, chest pain, cough, and subfebrile fever. She had history of SLE since 2015 (malar rash, photosensitivity, protein urine quantitative 166.5 mg/24 hours, anti ds-DNA 79.5 IU/mL, ANA Test positive) but patient wasn’t routinely treated since 6 months. Patient has stable hemodynamic condition, and muffled heart sound was heard. ECG showed low QRS voltage, chest x-ray appeared water bottle sign (suggestive of large pericardial effusion), autoimmune haemolytic anemia (Hb 6,2 g/dl, normocytic-normochromic anemia, direct coomb’s test positive), hypoalbuminemia (2,6 g/dL) were found on blood test, and echocardiography showed large pericardial effusion (>20 mm). Aspirated effusion volume during pericardiocentesis was 440 mL, pericardial fluid analysis showed exudate fluid, the cytology wasn’t found malignant cell. Patient was carried out together with etiology of the underlying disease, as well as anti-inflammatory therapy. Patient has improved then discharged after seven days admission.
A shortness of breath patient with autoimmune disease background need to consider that pericardial effusion has occurred. Diagnosis is based on clinical manifestations and investigations. The underlying etiology should be found. According to ESC Guidelines that severe effusions may evolve towards cardiac tamponade in up to one-third of cases, then pericardiosynthesis is needed without ruling out the underlying disease to prevent life-threatening conditions.
Keywords : Pericardial Effusion, Systemic Lupus Erythematosus, Pericardiosynthesis