• Description
  • Rare, noninfective form of endocarditis due to sterile platelet thrombus formation on the heart valves (usually mitral and aortic valves)
  • Libman-Sacks endocarditis: a type of noninfective endocarditis with verrucous vegetations in individuals with systemic lupus erythematosus or antiphospholipid syndrome
• Etiology
  • Malignancy (e.g., pancreatic adenocarcinoma)
  • Hypercoagulable states
  • Underlying trauma (e.g., from indwelling vascular catheters)
  • Previous rheumatic fever
  • Autoimmune conditions (e.g., systemic lupus erythematosus, rheumatoid arthritis, antiphospholipid syndrome)
  • Chronic infections (e.g., TB, pneumonia, osteomyelitis)
• Clinical features
  • Valves and cardiac function are rarely impaired.
  • Compared to Infective endocarditis, vegetations are easily dislodged and embolization is common, leading to hemorrhages under the nails, skin, and retina
  • Most affected individuals are asymptomatic until embolization occurs.
• Diagnostics
  • Negative blood cultures
  • Biopsy: sterile vegetations on either surface of the valve composed of immune complexes, mononuclear cells, and thrombi interwoven with fibrin strands