Role of Cardiologists in the Management of Systemic Lupus Erythematosus: First Reported Case of Three-vessel Disease in a Young Woman in Pakistan

Systemic lupus erythematosus (SLE) is a multi-system autoimmune disorder with predilection towards young women. SLE is associated with increased risk of incidence of cardiac diseases which include atherosclerosis and coronary artery disease (CAD) that can present clinically as angina or myocardial infarction (MI) or be clinically silent in the initial stages. Furthermore, the use of corticosteroids for the treatment of SLE exacerbates the risk of thrombosis, possibly resulting in adverse cardiovascular events in such patients. Antiphospholipid syndrome (APS) is another autoimmune condition which can occur in the setting of SLE, also resulting in hypercoagulability and thrombosis. This goes on to show how important a role cardiologists play in anticipating and managing the cardiac manifestations of SLE, which can significantly reduce the morbidity and mortality of SLE patients. Here we present a case of a young woman with SLE having three-vessel disease, presenting in the cardiac emergency department of Civil Hospital, Karachi with typical chest pain. This case is the first of its kind to be reported in Pakistan, to the best of our knowledge.