Aby Elizabeth S, Rosol Zachary, Simegn Mengistu A
Division of Internal Medicine, UCLA Medical Center, Los Angeles, CA, USA.
Division of Internal Medicine, Hennepin County Medical Center, Minneapolis, MN, USA.
J Gen Intern Med. 2016 Aug;31(8):964-9. doi: 10.1007/s11606-016-3640-3. Epub 2016 Mar 14.
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.
利布曼-萨克斯（Libman-Sacks，LS）心内膜炎是系统性红斑狼疮最常见的心脏表现之一。然而，它很少会导致严重并发症，包括严重的瓣膜反流或叠加的细菌性心内膜炎。我们描述了一名患者的初始诊断挑战、临床病程、影像学检查及组织病理学发现，该患者因LS心内膜炎的罕见并发症——急性二尖瓣穿孔，出现危及生命的狼疮并伴有咯血和呼吸衰竭。我们回顾了当前关于LS心内膜炎背景下瓣膜穿孔的文献。总之，尽管该病通常无症状且对血流动力学影响不大，但它可能导致因瓣膜穿孔引起的严重且可能致命的并发症，这可能需要紧急手术治疗。
