title: Valvulitis requiring triple valve surgery as an initial presentation of systemic lupus erythematosus.
abstract: Cardiac involvement is common in systemic lupus erythematosus. Classically, the term "verrucous endocarditis" was used to describe the noninfective vegetations seen on pathological inspection of heart valves. The wide use of echocardiography has led to increased frequency of detection of valve abnormalities, most commonly leaflet thickening. The vast majority of patients with systemic lupus erythematosus and valvular involvement are asymptomatic, with only a small minority progressing to hemodynamically significant pathology, generally after long disease duration. We report a patient with systemic lupus erythematosus and associated antiphospholipid syndrome, whose first presentation of disease consisted of severe, symptomatic valvular regurgitation of the mitral, aortic, and tricuspid valves requiring triple valve surgery.
authors.affiliation: Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York 10467, USA.
authors.forename: Eldad
authors.initials: E
authors.lastname: Einav
authors.forename: Alon
authors.initials: A
authors.lastname: Gitig
authors.forename: L Manuela
authors.initials: LM
authors.lastname: Marinescu
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Tanaka
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Spevack
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D004696:Endocarditis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*; D005260:Female; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D016896:Treatment Outcome; D014463:Ultrasonography