Severe Calcific Aortic Stenosis in Systemic Lupus Erythematosus: A Case Report and Literature Review

ABSTRACT

Severe calcific aortic stenosis (CAS) in patients with systemic lupus erythematosus (SLE) is exceptionally rare. SLE affects multiple organ systems, including the cardiovascular system. Cardiovascular mortality in SLE is approximately three times higher than in the general population, and cardiovascular morbidity affects about 25% of patients. Although valvular heart disease (VHD) is common in SLE, marked aortic stenosis, particularly severe CAS, remains uncommon. This case report describes a 60-year-old female patient with SLE and VHD who developed rapid progressive, severe, symptomatic CAS. A multidisciplinary heart team determined that she was at prohibitive risk for surgical aortic valve replacement, and she subsequently underwent high-risk transcatheter aortic valve implantation. No SLE flare occurred. Regular cardiovascular risk assessment and echocardiographic screening are essential for patients with SLE. Careful multidisciplinary and immunosuppressive management supports successful interventions while minimizing the risk of SLE flare.