A Case Report of A Life-Threatening Condition: Complete Heart Block Induced By Systemic Lupus Erythematosus

Authors

  • Yogi Puji Rachmawan Universitas Swadaya Gunung Jati
  • Arsha Pramudya Hasna Medika Cardiovascular Hospital, Cirebon, Indonesia
  • Witri Pratiwi Universitas Swadaya Gunung Jati, Cirebon, Indonesia
  • Irnizarifka Irnizarifka Universitas Sebelas Maret, Surakarta, Indonesia
  • Fawzia Haznah Nurul Imani Universitas Diponegoro, Semarang, Indonesia

DOI:

https://doi.org/10.46799/jhs.v7i4.2824

Keywords:

complete heart block, conduction block, myocarditis, pacemaker, systemic lupus erythematous

Abstract

Systemic lupus erythematous is often accompanied by complications in the cardiovascular system such as pericarditis, valvular disease, coronary artery disease, but complications in the conduction pathway are rare condition. Conduction system disorders such as complete heart block can cause life-threatening conditions and require immediate treatment. This case report describes a 43-year-old woman who presented with syncope and complete heart block. The patient received high-dose corticosteroid therapy but the complete heart block did not improve so a permanent pacemaker was implanted. This case showed that SLE complications in the cardiovascular system including the cardiac conduction system must be watched out for because it is a life-threatening condition.

References

Bharati, S., De La Fuente, D. J., Kallen, R. J., Freij, Y., & Lev, M. (1975). Conduction system in systemic lupus erythematosus with atrioventricular block. The American Journal of Cardiology, 35(2), 299–304. https://doi.org/10.1016/0002-9149(75)90017-X

Buch, M. H., Mallat, Z., Dweck, M. R., Tarkin, J. M., O’Regan, D. P., Ferreira, V., Youngstein, T., & Plein, S. (2024). Current understanding and management of cardiovascular involvement in rheumatic immune-mediated inflammatory diseases. Nature Reviews Rheumatology, 20(10), 614–634.

Du Toit, R., Karamchand, S., Doubell, A. F., Reuter, H., & Herbst, P. G. (2023). Lupus myocarditis: Review of current diagnostic modalities and their application in clinical practice. Rheumatology, 62(2), 523–534. https://doi.org/10.1093/rheumatology/keac409

Fan, Z., Han, Y., Sun, G., & Dong, Z. (2025). Immunosuppressant adherence after heart transplantation: a review on detection, prevention, and intervention strategies in a multidisciplinary. Frontiers in Cardiovascular Medicine, 12, 1558082.

Gómez-Barrado, J. J., García-Rubira, J. C., Polo Ostáriz, M. A., & Turégano Albarrán, S. (2002). Complete atrioventricular block in a woman with systemic lupus erythematosus. International Journal of Cardiology, 82(3), 289–292. https://doi.org/10.1016/S0167-5273(01)00590-3

Jobling, K., Rajabally, H., & Ng, W.-F. (2018). Anti-Ro antibodies and complete heart block in adults with Sjögren’s syndrome. European Journal of Rheumatology, 5(3), 194–196. https://doi.org/10.5152/eurjrheum.2018.18019

Karnabi, E., & Boutjdir, M. (2010). Role of calcium channels in congenital heart block. Scandinavian Journal of Immunology, 72(3), 226–234. https://doi.org/10.1111/j.1365-3083.2010.02439.x

Lazzerini, P. E., Murthy Ginjupalli, V. K., Srivastava, U., et al. (2023). Anti-Ro/SSA antibodies blocking calcium channels as a potentially reversible cause of atrioventricular block in adults. JACC: Clinical Electrophysiology, 9(12), 1631–1648. https://doi.org/10.1016/j.jacep.2023.03.007

Lo, C. H., Wei, J. C. C., Tsai, C. F., Li, L. C., Huang, S. W., & Su, C. H. (2018). Syncope caused by complete heart block and ventricular arrhythmia as early manifestation of systemic lupus erythematosus in a pregnant patient: A case report. Lupus, 27(10), 1729–1731. https://doi.org/10.1177/0961203318782425

Maier, W. P., Ramirez, H. E., & Miller, S. B. (1987). Complete heart block as the initial manifestation of systemic lupus erythematosus. Archives of Internal Medicine, 147(1), 170–171. https://doi.org/10.1001/archinte.1987.00370010168034

Miner, J. J., & Kim, A. H. J. (2014). Cardiac manifestations of systemic lupus erythematosus. Rheumatic Disease Clinics of North America, 40(1), 51–60. https://doi.org/10.1016/j.rdc.2013.10.003

Mishra, V., Chatterjee, T., & M. C. (2023). Complete heart block: An atypical presentation with an atypical diagnosis. International Journal of Research in Medical Sciences, 11(10), 3855–3858. https://doi.org/10.18203/2320-6012.ijrms20233045

Mohanty, B., & Sunder, A. (2020). Lupus myocarditis: A rare case. Journal of Family Medicine and Primary Care, 9(8), 4441. https://doi.org/10.4103/jfmpc.jfmpc_716_20

Natsheh, A., Shimony, D., Bogot, N., Nesher, G., & Breuer, G. S. (2019). Complete heart block in lupus. Lupus, 28(13), 1589–1593. https://doi.org/10.1177/0961203319881198

Opałka, B., Żołnierczuk, M., & Grabowska, M. (2023). Immunosuppressive agents—effects on the cardiovascular system and selected metabolic aspects: a review. Journal of Clinical Medicine, 12(21), 6935.

Pan, S.-Y., Tian, H.-M., Zhu, Y., et al. (2022). Cardiac damage in autoimmune diseases: Target organ involvement that cannot be ignored. Frontiers in Immunology, 13, 1056400. https://doi.org/10.3389/fimmu.2022.1056400

Popescu, M. R., Dudu, A., Jurcut, C., Ciobanu, A. M., Zagrean, A.-M., & Panaitescu, A. M. (2020). A broader perspective on anti-Ro antibodies and their fetal consequences: A case report and literature review. Diagnostics, 10(7), 478. https://doi.org/10.3390/diagnostics10070478

Shariff, R., Lim, C., & Kasim, S. (2020). Complete heart block in a 40-year-old man with anti-SSA/Ro autoantibodies. Proceedings of Singapore Healthcare, 30(4). https://doi.org/10.1177/2010105820978668

Tana, C., Kouranos, V., Bernardinello, N., Mantini, C., Scarpa, R., Cinetto, F., Israël-Biet, D., & Spagnolo, P. (2025). Redefining cardiac sarcoidosis with advanced imaging and therapeutic strategies. American Journal of Cardiovascular Drugs, 1–22.

Tanwani, J., Tselios, K., Gladman, D. D., Su, J., & Urowitz, M. B. (2018). Lupus myocarditis: A single center experience and a comparative analysis of observational cohort studies. Lupus, 27(8), 1296–1302. https://doi.org/10.1177/0961203318770018

Wahren-Herlenius, M., & Sonesson, S.-E. (2006). Specificity and effector mechanisms of autoantibodies in congenital heart block. Current Opinion in Immunology, 18(6), 690–696. https://doi.org/10.1016/j.coi.2006.09.012

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Published

2026-04-28