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All Endocarditis Is Not Infective: Libman-Sacks Endocarditis
Hilal Al Riyami1, Niranjan Joshi1, Khalfan Al Senaidi1
1Department of Child Health, Sultan Qaboos University Hospital, Muscat, OMN.
Cureus
|August 8, 2022
Summary
Libman-Sacks endocarditis, a rare heart valve disorder, can be a manifestation of systemic lupus erythematosus (SLE). Prompt diagnosis and treatment of SLE, including immunosuppressive therapy, can resolve heart failure symptoms caused by Libman-Sacks endocarditis.
Area of Science:
- Cardiology
- Rheumatology
- Internal Medicine
Background:
- Libman-Sacks endocarditis (LSE) is an uncommon cardiac manifestation of systemic lupus erythematosus (SLE).
- LSE can be mistaken for infective endocarditis and may present with heart failure.
- Cardiac involvement in SLE requires careful evaluation for accurate diagnosis and management.
Observation:
- A 12-year-old female presented with dyspnea, arthralgia, and fever, indicative of systemic illness.
- Physical examination revealed pallor, edema, and a new-onset pansystolic murmur consistent with mitral regurgitation.
- Diagnostic workup confirmed systemic lupus erythematosus with lupus nephritis and carditis.
Findings:
- Echocardiography demonstrated severe mitral regurgitation with characteristic nodular thickening of the valve leaflets, supporting the diagnosis of LSE.
- The patient's symptoms of heart failure were directly attributed to the cardiac manifestations of SLE.
- Treatment with immunosuppressive therapy led to significant clinical improvement and resolution of heart failure symptoms.
Implications:
- This case highlights the critical importance of considering LSE in the differential diagnosis of heart failure in young patients with SLE.
- Comprehensive cardiac evaluation, including echocardiography, is essential for accurate diagnosis and management of SLE-related carditis.
- Effective management of the underlying autoimmune disease can lead to favorable outcomes and resolution of cardiac dysfunction in LSE.
Keywords:
endocarditisheart failure.libman-sacks endocarditismitral valvesystemic lupus erythematosusMore Related Videos
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