Libman-Sacks endocarditis is a nonbacterial thrombotic endocarditis most classically associated with which condition, and which valvular surface is preferentially involved?

• A Rheumatoid arthritis; aortic valve on ventricular surface
• B Systemic lupus erythematosus; both surfaces of mitral and tricuspid valves ✓
• C Carcinoid syndrome; right-sided valves (pulmonary and tricuspid) on atrial surface
• D Marantic endocarditis in cancer; irregular masses on the line of closure of mitral valve

Explanation

Libman-Sacks endocarditis occurs in systemic lupus erythematosus (SLE) and antiphospholipid syndrome, characterized by small sterile vegetations on both surfaces (atrial AND ventricular) of the mitral and tricuspid valves — distinguishing it from other endocarditides. It is associated with antiphospholipid antibodies and IL-1/TNF-mediated valvular injury. Carcinoid endocarditis involves right-sided valves on the atrial surface. Marantic (NBTE) vegetations are on the line of closure of left-sided valves.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.