Libman–Sacks endocarditis

Libman–Sacks endocarditis is a form of nonbacterial thrombotic endocarditis (NBTE) that is seen in association with systemic lupus erythematosus (SLE). It was first described by the American pathologists Emanuel Libman and Benjamin Sacks in 1924.

Etiology

The exact cause of Libman–Sacks endocarditis is unknown, but it is closely associated with SLE and antiphospholipid syndrome (APS). It is thought to be due to the formation of autoantibodies in these conditions, which cause damage to the endothelium of the heart valves.

Pathology

Libman–Sacks endocarditis is characterized by the presence of sterile vegetations on the heart valves. These vegetations are composed of fibrin and platelets, and are often associated with underlying valve damage. The mitral valve is the most commonly affected, but any valve can be involved.

Clinical features

Patients with Libman–Sacks endocarditis may be asymptomatic, or they may present with symptoms of heart failure, stroke, or systemic embolism. The condition is often discovered incidentally during echocardiography for other reasons.

Diagnosis

The diagnosis of Libman–Sacks endocarditis is made by echocardiography, which shows the characteristic vegetations on the heart valves. Blood tests may show evidence of SLE or APS.

Treatment

The treatment of Libman–Sacks endocarditis involves managing the underlying SLE or APS. This may include immunosuppressive therapy and anticoagulation. In severe cases, valve replacement surgery may be necessary.

Prognosis

The prognosis of Libman–Sacks endocarditis is variable, and depends on the severity of the valve damage and the underlying SLE or APS. With appropriate treatment, the condition can often be managed effectively.

See also

• Endocarditis
• Systemic lupus erythematosus
• Antiphospholipid syndrome