Libman-Sacks endocarditis is a form of nonbacterial endocarditis classically associated with systemic lupus erythematosus (SLE). The valvular involvement typically starts with sterile vegetations but may progress, resulting in valvular dysfunction. Its pathogenesis appears to be correlated with the presence of antiphospholipid antibodies.


The mitral and aortic valves are the cardiac valves most often involved.


Initially there are sterile vegetations on the valves that may embolize to the brain or other sites. Vegetations may also appear on the chordae or nonvalvulae endocardium.


Echocardiography has shown thickening of the affected valve(s) over time.


The affected valve may become dysfunctional, usually resulting in regurgitation.


The presence of antiphospholipid antibodies appears to underly the appearance of the lesions and to affect the risk of thromboembolic complications.


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