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Retinal artery embolization complicating Libman-Sacks endocarditis in a systemic lupus erythematosus patient

Liliana Marta1, Maria Luz Pitta, Marisa Peres

  • 1Serviço de Cardiologia, Hospital de Santarém, Santarém, Portugal. liliana.marta@gmail.com

Revista Portuguesa De Cardiologia : Orgao Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology
|March 26, 2013
PubMed

Insights

Libman-Sacks endocarditis, a heart condition in systemic lupus erythematosus, can cause vision loss. Treatment with anticoagulation led to vegetation regression and prevented further embolic events.

Area of Science:

  • Cardiology
  • Rheumatology
  • Ophthalmology

Background:

  • Libman-Sacks endocarditis (LSE) is a cardiac manifestation of systemic lupus erythematosus (SLE).
  • LSE can lead to severe complications including valvular dysfunction, infective endocarditis, and embolic events.
  • Ocular complications, such as central retinal artery occlusion, are rare but serious manifestations of SLE.

Observation:

  • A patient with SLE presented with sudden blindness due to right central retinal artery occlusion.
  • Echocardiography revealed a verrucous vegetation on the mitral valve, characteristic of LSE.
  • The ocular event was attributed to embolic phenomena secondary to LSE.

Findings:

  • Anticoagulation therapy was initiated for the patient.
  • Echocardiographic follow-up demonstrated regression of the mitral valve vegetation.
  • No further thromboembolic events occurred during the follow-up period.

Implications:

  • This case highlights the potential for LSE to cause significant embolic events, including central retinal artery occlusion.
  • Early diagnosis and anticoagulation therapy may be crucial in managing LSE complications.
  • Ophthalmologists and rheumatologists should consider LSE in patients with SLE presenting with embolic events, particularly those affecting vision.

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