Libman–Sacks endocarditis

Libman–Sacks endocarditis (often misspelled Libmann–Sachs) is a form of nonbacterial endocarditis that is seen in association with systemic lupus erythematosus. It is one of the most common heart-related manifestations of lupus (the most common being pericarditis).[1]

Libman–Sacks endocarditis
Diagnostic methodTransesophageal echocardiography (TEE)

It was first described by Emanuel Libman and Benjamin Sacks at Mount Sinai Hospital in New York City in 1924.[2][3] The association between Libman–Sacks endocarditis and antiphospholipid syndrome was first noted in 1985.

Signs and symptoms

The vegetations are small and formed from strands of fibrin, neutrophils, lymphocytes, and histiocytes. The mitral valve is typically affected, and the vegetations occur on the ventricular and atrial surface of the valve. Libman–Sacks lesions rarely produce significant valve dysfunction and the lesions only rarely embolize.[4] However, there is data to suggest an association between Libman–Sacks endocarditis and a higher risk for embolic cerebrovascular disease in people with systemic lupus erythematosus (SLE).[5]


The pathology is the same as nonbacterial thrombotic endocarditis except focal necrosis with hematoxylin bodies can be found only in Libman–Sacks endocarditis.



Treatment can include:




  1. "Libman–Sacks endocarditis". Mosby's Medical, Nursing & Allied Health Dictionary (Fourth ed.). Mosby-YearBook, Inc. 1994. p. 907.
  2. Libman, E.; Sacks, B. (1924). "A hitherto undescribed form of valvular and mural endocarditis". Arch Intern Med. 33 (6): 701–737. doi:10.1001/archinte.1924.00110300044002.
  3. " Libman–Sacks Endocarditis". Retrieved 2008-08-11.
  4. Doherty, N. E.; Siegel, R. J. (1985). "Cardiovascular manifestations of systemic lupus erythematosus". Am Heart J. 110 (6): 1257–1265. doi:10.1016/0002-8703(85)90023-7. PMID 3907317.
  5. Roldan, C. A.; Sibbitt, W. L. Jr (2013). "Libman–Sacks endocarditis and embolic cerebrovascular disease". Cardiovascular Imaging. 6 (9): 973–983. doi:10.1016/j.jcmg.2013.04.012. PMC 3941465. PMID 24029368.
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