I hope you have had an echocardiogram to look at your heart to determine if you have systolic dysfunction or diastolic dysfunction. Lupus can cause both types. Unfortunately, it is usually a diagnosis of exclusion--we rule the other main causes of heart failure, and you have lupus, therefore it is probably lupus induced chf. Not a great way to make a diagnosis, but not much better options. However, if you do have systolic dysfunction, they need to make sure you do not have coronary disease--preferably by cardiac MRI, cardiac CT, or angiogram. Often we treat people for a presumed cause of CHF, and never really look at the coronaries--and that is the culprit. So first, get an echocardiogram--and if you have systolic dysfunction (where ejection fraction (LVEF) < 40%) make sure the doctors evaluate you for coronary disease.