A challenging course of Systemic Lupus Erythematosus with Valvular Heart Disease and Multisystem Involvement

Abstract

We present a complex case of Systemic Lupus Erythematosus (SLE) with secondary antiphospholipid syndrome (APS). Diagnosed initially with discoid lupus (2019) and progressed to severe systemic flare (Nephritis, hypocomplementemia, arthritis) by 2021, resulting in hypertension and cerebrovascular events. The clinical course was dominated by widespread encephalomalacia and new-onset epilepsy. Alongside progressive congenital aortic valve stenosis. Despite concern over non-sustained ventricular tachycardia (NSVT), it was successfully suppressed by beta-blockers. However, the patient developed overt heart failure in early 2024, due to advanced left ventricular hypertrophy (graded 54mmHg). Ultimately, aortic valve replacement (AVR) was performed. This case highlights the compounded thrombotic and inflammatory risk in SLE/APS and the importance of coordinated multidisciplinary management.