Liang Huili, Ma Chunyan, Chen Xin
Department of Cardiovascular Ultrasound, Clinical Medical Research Center of Imaging in Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, China.
Front Cardiovasc Med. 2022 Aug 18;9:985111. doi: 10.3389/fcvm.2022.985111. eCollection 2022.
Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by recurrent arteriovenous thrombosis and/or morbid pregnancy. Valve involvement is the most common cardiac manifestation of APS, with lesions characterized by valve thickening and vegetations known as Libman-Sacks endocarditis (LSE). This report discussed a rare case of a 26-year-old young woman diagnosed with primary APS with multiple cerebral infarctions and right middle cerebral artery occlusion that occured 3 years ago. During the investigation, transthoracic echocardiography (TTE) revealed vegetations on both leaflets of the mitral valve with mild to moderate mitral regurgitation. One year following corticosteroid and anticoagulant treatment, mitral valve fibrosis and moderate to severe regurgitation were noted, after which mitral mechanical valve replacement was finally performed. Accordingly, this report suggests that LSE occurrence should be alerted during the examination of APS patients especially in those with cerebrovascular disease. Furthermore, establishing an early diagnosis and conducting close follow-ups are necessary for its timely intervention and treatment.
抗磷脂综合征（APS）是一种全身性自身免疫性疾病，其特征为反复发生动静脉血栓形成和/或病态妊娠。瓣膜受累是APS最常见的心脏表现，病变特征为瓣膜增厚和出现称为Libman-Sacks心内膜炎（LSE）的赘生物。本报告讨论了一例罕见病例，一名26岁年轻女性被诊断为原发性APS，伴有3年前发生的多发性脑梗死和右大脑中动脉闭塞。在检查过程中，经胸超声心动图（TTE）显示二尖瓣两个瓣叶上有赘生物，伴有轻度至中度二尖瓣反流。在接受皮质类固醇和抗凝治疗一年后，发现二尖瓣纤维化和中度至重度反流，之后最终进行了二尖瓣机械瓣膜置换术。因此，本报告提示，在对APS患者进行检查时，尤其是对患有脑血管疾病的患者，应警惕LSE的发生。此外，早期诊断并进行密切随访对于及时干预和治疗是必要的。
