People with systemic lupus erythematosus may present with other symptoms of the underlying diseases that give rise to Libman–Sacks endocarditis.
[2] Libman–Sacks endocarditis occurs in association with systemic lupus erythematosus, antiphospholipid syndrome, and malignancies.
In some cases, Libman–Sacks endocarditis may be the presenting pathology in systemic lupus erythematosus, especially in the presence of concurrent antiphospholipid syndrome.
It is thought to occur in the context of a hypercoagulable state which leads to endothelial injury and subsequent deposition of thrombi and inflammatory molecules in affected valves.
The vegetations that are thus formed consist of immune complexes, platelet thrombi, fibrin, and mononuclear cells.
[2] Libman–Sacks endocarditis involves formation of cardiac lesions that may take the form of vegetations or thickening of the valvular leaflets.
[5] 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.
[4] Vegetations of the cardiac valves and endocardium are characterised by irregular borders, heterogenous echo density, and an absence of independent motion.
Anticoagulant treatment is recommended in cases with previous thromboembolic event for prevention of subsequent occurrences.