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Case Reports
. 2023 Apr 17;15(4):e37734.
doi: 10.7759/cureus.37734. eCollection 2023 Apr.

Libman-Sacks Endocarditis With Triple Valvular Involvement

Meeran Asher Syed  1 , Muhammad Usama Khokhar  2 , Farhan Akbar  3 , Muhammad Asfand  1 , Hassan Shakoor  1
Affiliations
Case Reports

Libman-Sacks Endocarditis With Triple Valvular Involvement

Meeran Asher Syed et al. Cureus. .

Abstract

Systemic lupus erythematosus (SLE) is a systemic inflammatory autoimmune disease with a broad spectrum of clinical manifestations. Libman-Sacks endocarditis (LSE) is due to sterile vegetations that arise in association with SLE. Nonbacterial thrombotic endocarditis, also known as marantic endocarditis, Libman-Sacks endocarditis, and verrucous endocarditis, is linked to a number of illnesses, the most prevalent of which is advanced cancer. Most often, the surfaces of mitral and aortic valves are involved. However, the involvement of the tricuspid valve is possible and is rarely described in the literature. We present a case of a 25-year-old female who presented with LSE, lupus nephritis, and pulmonary involvement secondary to SLE. On detailed exploration, she was found to have SLE with lupus nephritis and pulmonary hypertension secondary to valvular involvement. Through this case, we would like to elaborate on the course of SLE with triple valvular involvement.

Keywords: aps; autoimmune; sle; tricuspid valve endocarditis; trivalvular.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. TEE representing left ventricular function and ejection fraction
LV: left ventricle, IVSd: Interventricular septal end diastole, LVIDd: Left ventricular internal diameter end diastole, LVPWd: Left ventricular posterior wall end diastole, IVSs: Interventricular septal end-systole, LVIDs: Left ventricular internal diameter end-systole, LVPWs: Left ventricular posterior wall end-systole, EF: ejection fraction, LVFS: Left ventricular fractional shortening, LVEDV and LVESV: LV end-diastolic and end-systolic volumes, SV: Stroke Volume, IVS: interventricular septum, PW: Pulsed wave, RWT: Relative wall thickness
Figure 2
Figure 2. TEE representing the status of the mitral valve
MV: Mitral valve, MVE Vel: mitral valve flow E wave velocity, MVA Vel: mitral valve flow A wave velocity, PG: pressure gradient, E/A: E wave/A wave ratio, MV Dec T: MV Deceleration Time
Figure 3
Figure 3. TEE assessment of pulmonary capillary wedge pressure
e’lat:  diastolic left ventricular wall velocity of mitral annulus, E/e’lat: ratio of early diastolic mitral annulus velocity to early diastolic mitral annulus velocity, avg: average, PCWP: Pulmonary capillary wedge pressure
See this image and copyright information in PMC

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