Why the study?
Persistent Libman-Sacks endocarditis complicated by bacterial endocarditis can cause acute valve regurgitation, acute heart failure, and cardiogenic shock, which are rare in pregnant patients.
Case Report (n=1)
No
Highlights the rare presentation of combined bacterial and Libman-Sacks endocarditis in a pregnant patient with undiagnosed SLE, emphasizing the need for careful evaluation of atypical manifestations.
May support combined surgery and immunomodulation in rare mixed endocarditis during pregnancy; leaves open validation in larger studies.
Background: As one of the most common cardiac manifestations of systemic lupus erythematous (SLE), Libman-Sacks (LS) endocarditis is a nonbacterial form of thrombotic endocarditis characterized by sterile vegetations deposited on heart valves consisting of fibrin mixed with immune complexes and platelets. Although patients with LS endocarditis usually have no significant valvular disease, persistent LS endocarditis may be complicated by bacterial endocarditis, leading to serious complications, including acute valve regurgitation, acute heart failure, and even cardiogenic shock, which are rare in pregnant patients. Therefore, such patients with atypical SLE manifestations combined with various complications deserve more attention. Case presentation: We reported a rare case of a pregnant patient without an SLE history who progressed to cardiogenic shock resulting in a preterm birth. After the delivery of the fetus, it was considered that the patient had bacterial endocarditis according to the results of lab tests and echocardiography. LS endocarditis was also found after surgery. Moreover, SLE with catastrophic antiphospholipid syndrome (CAPS) was also confirmed during the course of treatment. Finally, the combined use of methylprednisolone and human immunoglobulin injection was carried out, the patient’s condition improved, and she was discharged on the 13th postoperative day. Conclusion: The interference of infective endocarditis with the type of preexisting lesion in the disease process can influence our judgment and treatment decisions, which is worth noting.
No takes yet. Share an insight, caveat, or question.
Chen et al. (2023) conducted a case report in Cardiogenic shock due to bacterial endocarditis combined with Libman-Sacks endocarditis (n=1). Mitral valve replacement and immunosuppressive therapy was evaluated on Patient survival and clinical recovery.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: