ENDOCARDIAL INVOLVEMENT IN SYSTEMIC AUTOIMMUNE DISEASES: PATHOPHYSIOLOGY, CLINICAL MANIFESTATIONS, AND MANAGEMENT

Karol Szyprowski; Jakub Skrzypek; Natalia Fidut; Kamila  Zioło; Weronika Zarzycka; Maciej Kisielewski; Julia Wawerska; Weronika Wrzosek; Bartosz Okliński; Mateusz Zugaj

doi:10.31435/ijitss.2(50).2026.5388

Authors

Karol Szyprowski 1st Military Clinical Hospital with Outpatient Clinic, Independent Public Healthcare Institution in Lublin 23 Racławickie Avenue, 20-049 Lublin Lublin Voivodeship, Poland https://orcid.org/0009-0001-0336-6425
Jakub Skrzypek Stefan Cardinal Wyszyński Provincial Specialist Hospital SPZOZ in Lublin Al. Kraśnicka 100, 20-718 Lublin, Poland https://orcid.org/0009-0004-1155-5818
Natalia Fidut Stefan Cardinal Wyszyński Provincial Specialist Hospital SPZOZ in Lublin Al. Kraśnicka 100, 20-718 Lublin, Poland https://orcid.org/0009-0006-2550-3933
Kamila Zioło 1st Military Clinical Hospital with the Outpatient Clinic, Lublin, Poland al. Racławickie 23, 20-049 Lublin, Poland https://orcid.org/0009-0003-3875-4000
Weronika Zarzycka 1st Military Clinical Hospital with the Outpatient Clinic, Lublin, Poland al. Racławickie 23, 20-049 Lublin, Poland https://orcid.org/0009-0004-1927-4076
Maciej Kisielewski Stefan Cardinal Wyszyński Provincial Specialist Hospital SPZOZ in Lublin Al. Kraśnicka 100, 20-718 Lublin, Poland https://orcid.org/0009-0003-1797-9155
Julia Wawerska Medical University of Lodz, Łódź, Poland https://orcid.org/0009-0006-0145-6204
Weronika Wrzosek University Clinical Hospital No. 1 in Lublin ul. Stanisława Staszica 16, 20-081 Lublin, Poland https://orcid.org/0009-0002-6680-5760
Bartosz Okliński Stefan Cardinal Wyszyński Provincial Specialist Hospital SPZOZ in Lublin Al. Kraśnicka 100, 20-718 Lublin, Poland https://orcid.org/0009-0003-9018-6784
Mateusz Zugaj Stefan Cardinal Wyszyński Provincial Specialist Hospital SPZOZ in Lublin Al. Kraśnicka 100, 20-718 Lublin, Poland https://orcid.org/0009-0000-2848-6952

DOI:

https://doi.org/10.31435/ijitss.2(50).2026.5388

Keywords:

Libman-Sacks Endocarditis, Antiphospholipid Syndrome, Cardiac Complications, Multidisciplinary Management

Abstract

Purpose: The manuscript aims to highlight the clinical significance of Libman-Sacks endocarditis (LSE) in patients with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS). It emphasizes the importance of early diagnosis and multidisciplinary management to prevent severe cardiac complications and improve patient outcomes.

Methodology: A comprehensive review of recent literature and case studies was conducted, focusing on the pathogenesis, clinical presentation, diagnostic approaches, and management strategies for LSE in SLE and APS patients. The article synthesizes evidence from published research, including echocardiographic findings, laboratory markers, and therapeutic interventions

Findings: LSE is frequently underdiagnosed due to its subtle clinical manifestations. Echocardiography remains the gold standard for detection, revealing characteristic vegetations on heart valves. The manuscript identifies a strong association between LSE and thromboembolic events in SLE/APS patients. Multidisciplinary collaboration among cardiologists, rheumatologists, hematologists, and cardiac surgeons is crucial for optimal management. Anticoagulation and immunosuppressive therapy are central to treatment, with surgical intervention reserved for severe cases.

Conclusions: Early recognition and coordinated care are essential to reduce morbidity and mortality associated with LSE in SLE and APS. The article advocates for routine cardiac screening in high-risk patients and underscores the need for further research to refine diagnostic and therapeutic protocols.

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