Endocardial Involvement in Systemic Autoimmune Diseases: Pathophysiology, Clinical Manifestations, and Management

Purpose: The manuscript aims to highlight the clinical significance of Libman-Sacks endocarditis (LSE) in patients with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS). It emphasizes the importance of early diagnosis and multidisciplinary management to prevent severe cardiac complications and improve patient outcomes. Methodology: A comprehensive review of recent literature and case studies was conducted, focusing on the pathogenesis, clinical presentation, diagnostic approaches, and management strategies for LSE in SLE and APS patients. The article synthesizes evidence from published research, including echocardiographic findings, laboratory markers, and therapeutic interventions Findings: LSE is frequently underdiagnosed due to its subtle clinical manifestations. Echocardiography remains the gold standard for detection, revealing characteristic vegetations on heart valves. The manuscript identifies a strong association between LSE and thromboembolic events in SLE/APS patients. Multidisciplinary collaboration among cardiologists, rheumatologists, hematologists, and cardiac surgeons is crucial for optimal management. Anticoagulation and immunosuppressive therapy are central to treatment, with surgical intervention reserved for severe cases. Conclusions: Early recognition and coordinated care are essential to reduce morbidity and mortality associated with LSE in SLE and APS. The article advocates for routine cardiac screening in high-risk patients and underscores the need for further research to refine diagnostic and therapeutic protocols.