Abstract
Background: Libman Sacks Endocarditis is rare, nonbacterial vegetation of the heart valves. Most commonly seen in association with solid cancers and autoimmune diseases. Case: A 64-year-old male came in with sudden onset left upper arm numbness, pain and pallor which worsened with movement. On examination, he had feeble pulses of the left upper extremity and an aortic diastolic murmur of the heart. He underwent an angiogram which revealed decreased flow distal to the brachial artery and therefore was scheduled for an emergent embolectomy. An echocardiogram showed a mass on the aortic valve. Repetitive blood cultures were negative. Autoimmune workup showed positive lupus anticoagulant and cardiolipin IgM, possibly suggesting antiphospholipid syndrome. Unfortunately, we were unable to follow up on the thrombophilia workup at 12 weeks. Conclusion: Autoimmune disease has a strong association with Libman Sacks endocarditis, treatment with warfarin is preferred and valve replacement is necessary in some cases.
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