[Cardiac involvement in antiphospholipid syndrome]

Area of Science:

• Cardiology
• Rheumatology
• Immunology

Context:

• Antiphospholipid syndrome (APS) is a rare autoimmune disorder characterized by recurrent thrombotic events or pregnancy morbidity.
• Cardiac manifestations in APS are infrequent but associated with significant morbidity and mortality.
• Understanding the spectrum and prognosis of cardiac involvement in APS is critical for patient management.

Purpose:

• To summarize the cardiac manifestations of antiphospholipid syndrome (APS).
• To discuss the diagnostic features and prognostic implications of cardiac involvement in APS.
• To outline current therapeutic strategies for cardiac APS.

Summary:

• Cardiac involvement in APS, though uncommon, can affect all cardiac structures, with endocardial and coronary artery involvement carrying a poor prognosis.
• Catastrophic APS (CAPS) can present with cardiac symptoms, necessitating prompt recognition and management.
• Anticoagulation is the cornerstone of treatment for most cardiac APS cases, except for catastrophic variants which may require additional therapies.

Impact:

• Highlights the importance of considering cardiac evaluation in APS patients, even with infrequent presentation.
• Emphasizes the poor prognosis associated with specific cardiac involvements like coronary arteries.
• Informs clinical practice regarding the gold standard treatment (anticoagulation) for non-catastrophic cardiac APS.