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Valvulitis requiring triple valve surgery as an initial presentation of systemic lupus erythematosus

Eldad Einav1, Alon Gitig, L Manuela Marinescu

  • 1Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York 10467, USA.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|June 30, 2007
PubMed

Insights

Systemic lupus erythematosus commonly affects the heart, often causing valve issues. This case highlights severe, symptomatic valve regurgitation as a primary presentation, necessitating triple valve surgery.

Area of Science:

  • Cardiology
  • Rheumatology
  • Pathology

Background:

  • Cardiac involvement is a frequent complication of systemic lupus erythematosus (SLE).
  • Historically, noninfective vegetations were termed 'verrucous endocarditis'.
  • Echocardiography increases detection of SLE-related valve abnormalities, typically leaflet thickening.

Observation:

  • Most SLE patients with valvular disease are asymptomatic.
  • Significant valve pathology usually develops after prolonged disease duration.
  • This report details a patient whose initial presentation was severe, symptomatic valve regurgitation.

Findings:

  • The patient had SLE and antiphospholipid syndrome.
  • Severe regurgitation affected the mitral, aortic, and tricuspid valves.
  • Triple valve surgery was required as the initial treatment.

Implications:

  • Severe symptomatic valvular regurgitation can be the first manifestation of SLE and antiphospholipid syndrome.
  • Early recognition and intervention are crucial for patients presenting with severe cardiac compromise.
  • This case underscores the spectrum of cardiac manifestations in SLE.

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