Libman-Sacks endocarditis (non-bacterial thrombotic endocarditis) is a cardiac complication of SLE. It differs from infective endocarditis by its characteristic location of vegetations. Where are the vegetations located in Libman-Sacks endocarditis?

• A On the ventricular surface of the mitral valve, predominantly on chordae tendinae
• B On the atrial surface of the mitral valve only, at the base of the leaflets
• C Both surfaces (atrial and ventricular) of the mitral valve leaflets, along the line of closure ✓
• D On the jet lesion of the endocardium opposite the regurgitant stream

Explanation

Libman-Sacks endocarditis is characterised by small, flat, sterile vegetations deposited on both surfaces (atrial and ventricular surfaces) of valvular leaflets, typically along and at the line of closure. This bilaterality distinguishes it from rheumatic endocarditis (vegetations on atrial surface only, at line of closure) and infective endocarditis (larger, irregular vegetations predominantly on ventricular surface of AV valves). The pathogenesis involves immune complex deposition and antiphospholipid antibody-mediated endothelial injury in SLE patients.

Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.