[Papillary muscle rupture as a manifestation of SLE in the puerperium].

Systemic Lupus Erythematosus (SLE) and Antiphospholipid Syndrome (APS) are two autoimmune diseases that may have serious cardiovascular manifestations, especially when associated. We report the clinical case of a young female, in the puerperium, with SLE in acute phase, who developed a sudden heart failure due to rupture of the papillary muscle. She underwent emergent cardiac surgery, with replacement of the mitral valve by a biological prosthesis. The postoperative course had no major intercurrences. Catastrophic SAF was concluded as a final diagnosis, due to the presence of anti-phospholipid antibody, to the attainment of multiple organs by thromboembolic phenomena, with histological documentation of micro-thrombi in cardiac tissue. This condition has a mortality rate of about 50%, despite treatment.