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European Journal of Echocardiography 2008 9(1):192-193; doi:10.1093/ejechocard/jem067
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2007. For permissions please email: journals.permissions@oxfordjournals.org

Libman–Sacks endocarditis and cerebral embolization in antiphospholipid syndrome

Mai Tone Lønnebakken1,2,* and Eva Gerdts1,2

1 Department of Heart Disease, Haukeland University Hospital, 5021 Bergen, Norway
2 Institute of Medicine, University of Bergen, Norway

Received 28 July 2007; accepted after revision 2 September 2007.

* Corresponding author. Tel: +47 55 97 22 20; fax: +47 55 97 51 00. E-mail address: mai.tone.lonnebakken{at}helse-bergen.no


  Abstract

In antiphospholipid syndrome (APS), there is a high prevalence of valvular heart disease which leads to increased risk of thrombo-embolic events, in particular, cerebrovascular events. We present a patient with cerebral infarction, previous deep-vein thrombosis, and miscarriages with positive lupus anticoagulant and anticardiolipin antibodies. Echocardiographic examination revealed mitral valve leaflet thickening and verrucous vegetations consistent with Libman–Sacks endocarditis, which is commonly associated with APS. In patients with combined Libman–Sacks endocarditis and antiphospholipid antibodies, anticoagulation therapy with warfarin is indicated due to high risk of valvular thrombus formation and subsequent embolization.

Keywords: Antiphospholipid syndrome; Libman–Sacks endocarditis; Cerebral embolism


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