Systemic lupus erythematosus (SLE) can manifest with diverse cardiac presentations, with pericarditis being the most common. However, myocarditis, albeit rare, poses significant risks. Here, we present the case of a 20-year-old woman initially diagnosed with tuberculosis but later found to have lupus myocarditis, a rare complication of SLE. She presented with features of left ventricular failure and pericardial effusion, demonstrating the importance of considering alternative diagnoses in such cases. Prompt management with supportive care and oral steroids led to eventual improvement.