The Heart and APS

Area of Science:

• Cardiology
• Rheumatology
• Immunology

Background:

• Antiphospholipid syndrome (APS) is an autoimmune disorder.
• The heart is a known target organ in APS, with various cardiovascular manifestations.
• Understanding these cardiac impacts is crucial for patient management.

Observation:

• Valvular involvement is the most common cardiac manifestation in APS, affecting 82% of patients.
• Characteristic findings include symmetrical, nodular thickening of the mitral and/or aortic valves.
• Other cardiac issues include endocardial disease, intracardiac thrombosis, and pulmonary hypertension.

Findings:

• Anticoagulant and antiplatelet therapies do not reverse valvular lesions in APS.
• Intracardiac thrombosis is a rare but serious complication, potentially causing emboli.
• Cardiac valve replacement may be necessary but is associated with increased perioperative risks.

Implications:

• Current treatments are insufficient for managing APS-related valvular heart disease.
• Increased perioperative morbidity and mortality highlight the challenges of surgical interventions in APS patients.
• Further research is needed to explore effective therapeutic strategies and improve surgical outcomes for APS patients with cardiac involvement.