Libman–Sacks endocarditis and cerebral embolization in antiphospholipid syndrome

In antiphospholipid syndrome (APS), there is a high prevalence of valvular heart disease which leads to increased risk of thrombo-embolic events, in particular, cerebrovascular events. We present a patient with cerebral infarction, previous deep-vein thrombosis, and miscarriages with positive lupus anticoa-gulant and anticardiolipin antibodies. Echocardiographic examination revealed mitral valve leaflet thickening and verrucous vegetations consistent with Libman–Sacks endocarditis, which is commonly associated with APS. In patients with combined Libman–Sacks endocarditis and antiphospholipid anti-bodies, anticoagulation therapy with warfarin is indicated due to high risk of valvular thrombus for-mation and subsequent embolization