A 40-year-old woman with SLE and antiphospholipid antibody syndrome presents with embolic stroke. Echocardiography shows small, irregular vegetations on both sides of the mitral valve leaflets. Blood cultures are negative. What is the most likely diagnosis?

• A Infective endocarditis
• B Atrial myxoma
• C Rheumatic valvulitis
• D Libman-Sacks endocarditis ✓

Explanation

Libman-Sacks endocarditis is characterised by sterile vegetations on either or both sides of the valve leaflets (both surfaces, unlike infective endocarditis which is typically on the upstream surface). It is strongly associated with SLE and antiphospholipid antibody syndrome. The vegetations are small, verrucous, and can cause systemic emboli. It is a non-infectious condition with negative blood cultures.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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