A Woman with Systemic Lupus Erythematosus and Odd Valvular Presentation: A Case Report

Patient: Female, 35 Final Diagnosis: Lupus induced valvular stenosis Symptoms: Fever Medication: — Clinical Procedure: Cardiac surgery Specialty: Cardiology OBJECTIVE: Unusual clinical course BACKGROUND: Systemic lupus erythematosus (SLE) is a systemic disease with various cardiac and non-cardiac presentations. We present the case of a young woman with odd presentation of SLE mistakenly identified as a valve abscess that was scheduled for surgery. CASE REPORT: This 35-year-old woman presented with rapid progression of aortic stenosis, and the transesophageal echo-cardiography report showed a misdiagnosed aortic web (congenital) and aortic wall abscess. She was scheduled for surgery as a case of subacute bacterial endocarditis (SBE) and aortic abscess, despite lack of fever. CONCLUSIONS: Cardiovascular involvement should be considered in any SLE patient, especially those with high SLE scores, even with negative antiphospholipid antibody. Cardiovascular involvement may be odd and misleading in some cases, which may warrant especial attention and experienced caregivers for clinical reasoning and proper management.