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Dissolution of intracardiac mass lesions in the primary antiphospholipid antibody syndrome
Insights
Antiphospholipid antibody syndrome can cause cardiac masses. Systemic anticoagulation effectively resolved these intracardiac lesions in three patients, suggesting it as a primary treatment before surgery.
Area of Science:
- Cardiology
- Rheumatology
- Immunology
Background:
- Antiphospholipid antibody syndrome (APS) presents with diverse cardiac issues, including valvular abnormalities and intracardiac masses.
- These masses can mimic other conditions like atrial myxomas, potentially leading to unnecessary surgery.
- Limited prospective data exists on managing intracardiac lesions in APS.
Observation:
- Three APS patients with intracardiac masses (atrial and mitral valve) experienced systemic embolization.
- These patients were prospectively monitored for their cardiac lesions.
Findings:
- Systemic anticoagulation therapy resulted in complete resolution of intracardiac masses within 6 weeks to 3 months.
- No surgical intervention was required for these specific cases.
Implications:
- Initial management of intracardiac lesions in APS should prioritize a trial of systemic anticoagulation.
- This approach may prevent invasive procedures and improve patient outcomes.
- Further prospective studies are warranted to confirm these findings.
Abstract:
The antiphospholipid antibody syndrome has numerous cardiac manifestations, including valvular thickening, insufficiency, and mass lesions. The mass lesions may be confused with atrial myxomas and other vegetations, sometimes necessitating a surgical diagnosis. There are no prospective studies on treatment or follow-up of intracardiac lesions in antiphospholipid antibody syndrome. We prospectively followed up three patients with antiphospholipid antibody syndrome for intracardiac lesions (one atrial and two mitral valve masses) complicated by systemic embolization. Anticoagulation led to complete resolution of the masses in 6 weeks to 3 months. We propose that initial treatment of an intracardiac lesion in patients with antiphospholipid antibody syndrome should be a trial of systemic anticoagulation before surgical intervention.