Postpartum Cardiac Dysfunction of Autoimmune Etiology: Lupus Myocarditis and Antiphospholipid Syndrome Triggering Cardiogenic Shock

This report examines the rare intersection of peripartum complications and autoimmune diseases, focusing on acute myocarditis linked to systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) causing cardiogenic shock. Case Presentation A 34-year-old woman with chronic hypertension and two prior cesarean sections presented at 35 weeks’ gestation with preeclampsia and fetal growth restriction. After an emergency cesarean section, she returned two weeks postpartum with fever, dyspnea, chest pain, and joint pain. Diagnostic evaluation revealed cardiomegaly, pulmonary edema, and severe left ventricular dysfunction (29% ejection fraction). Autoimmune testing confirmed SLE and APS, leading to a diagnosis of acute myocarditis. Treatment with inotropic support, diuretics, and immunosuppression improved her condition, and she was discharged with ongoing care. Conclusion This case highlights the challenge of differentiating autoimmune cardiac complications from peripartum cardiomyopathy and emphasizes the need for early recognition and multidisciplinary management.