Libman–Sacks endocarditis is a form of non-bacterial endocarditis that is seen in association with systemic lupus erythematosus, antiphospholipid syndrome, and malignancies. It is one of the most common cardiac manifestations of lupus (the most common being pericarditis).
Presentation
Libman–Sacks endocarditis itself is typically asymptomatic. Affected persons most commonly present with embolisms secondary to dislodged vegetations. However, in some cases, severe valvular dysfunction may develop. People with systemic lupus erythematosus may present with other symptoms of the underlying diseases that give rise to Libman–Sacks endocarditis.
Complications
Libman–Sacks endocarditis may result in arterial emboli, valvular insufficiency, and heart failure. Infective endocarditis occurs more frequently with those with systemic lupus erythematosus.
Emboli
Vegetations occurring in the context of Libman–Sacks endocarditis may dislodge to form emboli and cause embolism (including cerebral embolism (presenting as stroke or transient ischaemic attack), mesenteric ischaemia (presenting with severe abdominal pain), or peripheral arterial embolism (presenting with limb coldness)). Vegetations are most often small-to-moderate in size (up to 10 mm), The association between Libman–Sacks endocarditis and antiphospholipid syndrome was first noted in 1985.