title: Mitral Valve Perforation in Libman-Sacks Endocarditis: A Heart-Wrenching Case of Lupus.
abstract: Libman-Sacks (LS) endocarditis is one of the most common cardiac manifestations of systemic lupus erythematosus. Rarely, however, it can lead to serious complications, including severe valvular regurgitation or superimposed bacterial endocarditis. We describe the initial diagnostic challenges, clinical course, imaging studies and histopathological findings of a patient who presented with life-threatening lupus complicated by hemoptysis and respiratory failure secondary to a rare complication of LS endocarditis, acute mitral valve perforation. We review the current literature on valve perforation in the setting of LS endocarditis. In conclusion, although the disease is often asymptomatic and hemodynamically insignificant, it can result in serious and potentially fatal complications secondary to valve perforation, which may demand emergency surgical management.
authors.affiliation: Division of Internal Medicine, UCLA Medical Center, Los Angeles, CA, USA. eaby@mednet.ucla.edu.
authors.forename: Elizabeth S
authors.initials: ES
authors.lastname: Aby
authors.affiliation: Division of Internal Medicine, Hennepin County Medical Center, Minneapolis, MN, USA.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Rosol
authors.affiliation: Division of Cardiology, Hennepin County Medical Center, Minneapolis, MN, USA. Mengistu.Simegn@hcmed.org.
authors.forename: Mengistu A
authors.initials: MA
authors.lastname: Simegn
mesh_terms: D000328:Adult; D004452:Echocardiography; D004562:Electrocardiography; D004697:Endocarditis, Bacterial / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000000981:diagnostic imaging* / Q000628:therapy; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000628:therapy
keywords: Libman–Sacks endocarditis; endocarditis; lupus carditis; valve perforation; vegetation