Regression of lupus endocarditis after treatment of an arteriovenous fistula.
A young woman with systemic lupus erythematosus (SLE) and antiphospholipid antibodies was referred to our Cardiology Department. She had a large vegetation on the mitral valve, along with significant mitral regurgitation, pulmonary hypertension and slight signs of heart failure on physical examination and chest X-ray. A previously undetected iatrogenic arteriovenous fistula was surgically corrected, with subsequent normalization of pulmonary arterial pressure. Surprisingly, the mitral valve recovered a normal appearance in 21 days. We interpret the hemodynamic disturbances as a consequence of the high-output situation created by the fistula, and the regression of the vegetation as the lysis of a thrombus versus a silent embolism.
Herreros-Guilarte
B
B
Servicio de Cardiología, Hospital Universitario Marqués de Valdecilla, Facultad de Medicina, Universidad de Cantabria, Santander, Spain.
Golpe-Gómez
R
R
Berrazueta
J R
JR
D000328:Adult; D017153:Antibodies, Anticardiolipin / Q000097:blood; D001164:Arteriovenous Fistula / Q000150:complications* / Q000601:surgery; D004696:Endocarditis / Q000097:blood / Q000150:complications / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging / Q000209:etiology; D007049:Iatrogenic Disease; D007866:Leg / Q000098:blood supply / Q000473:pathology; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000276:immunology; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology; D009336:Necrosis; D014463:Ultrasonography
D017153:Antibodies, Anticardiolipin