Endocardite de Libman-Sachs et accident vasculaire cérébral ischémique : à propos d'un cas

IF 0.3 Q4 Medicine Annales de cardiologie et d'angeiologie Pub Date : 2024-09-23 DOI:10.1016/j.ancard.2024.101801

M.C. Hoara , B. Simorre , M.R. Belabed , P. Berdague , F. Georger

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Abstract

Libman-Sacks endocarditis is a rare cardiac manifestation of anti-phospholipid syndromes, in which non-infectious thrombotic vegetations are found on the heart valves. Most patients are asymptomatic whereas the risk of thromboembolism is considerable. Diagnostic work-up is based on questioning and clinical examination data looking for extracardiac signs, biological data and also on imaging, and, above all, echocardiography.

We report the case of a 47-year-old female patient with no known history who is admitted to hospital with paresthesia of the right hemi-body associated with dysarthria. Cerebral CT scan confirms a paraventricular ischemic stroke. The etiological work-up for stroke is negative except the transesophageal echocardiogram which reveals mitral valve vegetations. Further investigations lead to the diagnosis of Libman-Sacks endocarditis. Treatment with Coumadin is started, with a target INR of between 2 and 3, as recommended. The clinical course was favourable, with stable lesions on transoesophageal echocardiography carried out later.

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利伯曼-萨克斯心内膜炎与缺血性中风：病例报告

利伯曼-萨克斯（Libman-Sacks）心内膜炎是抗磷脂综合征的一种罕见心脏表现，在这种疾病中，心脏瓣膜上会出现非感染性血栓植被。大多数患者没有症状，但血栓栓塞的风险却相当大。我们报告了一例 47 岁女性患者的病例，该患者无任何病史，因右半身麻痹并伴有构音障碍而入院。脑 CT 扫描证实为脑室旁缺血性中风。除了经食道超声心动图发现二尖瓣植被外，中风的病因检查结果均为阴性。进一步检查后诊断为利伯曼-萨克斯心内膜炎。根据建议，开始使用 Coumadin 治疗，目标 INR 值为 2 至 3。临床疗效良好，随后进行的经食道超声心动图检查显示病变稳定。

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来源期刊

Annales de cardiologie et d'angeiologie 医学-外周血管病

CiteScore

0.60

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Organe scientifique de référence fondé en 1951, les Annales de cardiologie et d''angéiologie abordent tous les domaines qui intéressent quotidiennement les cardiologues et les angéiologues praticiens : neurologie et radiologie vasculaires, hémostase, diabétologie, médecine interne, épidémiologie et prévention. Les Annales de cardiologie et d''angéiologie sont indexées aux grandes bases de données et publient rapidement, et en conformité avec les normes internationales de publication scientifique, des articles en français sur la pathologie cardiaque.