European Journal of Cardio-Thoracic Surgery, Vol 5, 386-387, Copyright © 1991 by European Association for Cardio-thoracic Surgery
An unusual presentation of systemic lupus erythematosus
R Uppal, MN Sheppard and P Magee
Department of Cardiothoracic Surgery, London Chest Hospital, UK.
A case of right hemiparesis in a 22-year-old, caucasian male is presented.
Echocardiography and an indirect left ventriculogram revealed a mass in the
left ventricle which was eventually removed at surgery. Histology of the
ventricular wall revealed thrombus superimposed on a full thickness
myocardial infarction with florid intimal proliferation of small arteries.
This histological picture suggested a diagnosis of systemic lupus
erythematosus. Serum immunology revealed raised antibody titres in keeping
with systemic lupus erythematosus. This is an unusual presentation where
the only manifestation of disease was hemiparesis secondary to an embolic
episode, from thrombus in the left ventricle subsequent to a small
localised myocardial infarct.