Related Experiment Video
Updated: Jan 9, 2026

Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis
Published on: August 26, 2025
Severe Aortic Stenosis and Dual Valve Vegetations: An Uncommon Presentation of Primary Antiphospholipid Syndrome
Séline F S van der Woude1, Floris A Valentijn2, M Louisa Antoni3
1Department of Cardiology, Reinier de Graaf Hospital, Delft, the Netherlands; Department of Cardiology, Haga Hospital, The Hague, the Netherlands.
Background:
Primary antiphospholipid syndrome (PAPS) may cause thromboembolic events and valvular heart disease.
Case Summary:
A 42-year-old woman with a history of pre-eclampsia, epilepsy, and thrombocytopenia presented with acute chest pain and shortness of breath. Investigations revealed vegetation on both the aortic and mitral valves, severe aortic stenosis, and a non-ST-segment elevation myocardial infarction. Autoimmune testing confirmed antiphospholipid antibodies, which led to a diagnosis of PAPS with Libman-Sacks endocarditis, as well as secondary coronary embolic complications. After multidisciplinary consultation, the patient received anticoagulation, immunosuppressive therapy, and plasmapheresis.
Discussion:
This case report underlines the aggressive nature of PAPS, particularly given its presentation of severe aortic stenosis and dual valve involvement in a relatively young patient. To our knowledge, this is the first reported case of such a presentation.
Take-Home Message:
PAPS can manifest with fulminant cardiac manifestations including severe aortic stenosis, dual valve vegetations, and myocardial infarction, emphasizing the importance of early recognition and management.
Related Concept Videos
Mitral Stenosis I: Introduction
Aneurysm II: Clinical Manifestations and Diagnostic Studies
Mitral Stenosis III: Medical Management
Rheumatic Heart Disease I: Introduction
Aortic Regurgitation III: Medical Management
Aortic Regurgitation II: Clinical Features and Diagnostic Tests

