Libman-Sacks Endocarditis in a Congenital Valve Defect: A Case Report

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Abstract Background: Libman-Sacks endocarditis (LSE) is a rare complication of systemic lupus erythematosus (SLE) characterized by non-infectious vegetations on normal heart valves. Here, we present a case of SLE with a congenital valve malformation. Case presentation: The patient, a 20-year-old, had been undergoing treatment for SLE for one year with a good response. One year later, she presented with stage IV dyspnea and chest pain, accompanied by signs of right heart failure on clinical examination. Investigations revealed active lupus and vegetations on the mitral valve, along with agenesis of the posterior mitral leaflet and severe mitral insufficiency on echocardiography. The patient received corticosteroids, antibiotics, anticoagulants, and symptomatic treatment for heart failure. Despite initial clinical improvement, the patient's condition worsened and did not respond to resuscitation measures. Conclusion: While LSE typically responds favorably to treatment, severe valvulopathy, as seen in our patient with congenital valve malformation, can lead to fatal outcomes.

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