Young Stroke Following Libman-Sacks Endocarditis associated with Systemic Lupus Erythematosus and Secondary Antiphospholipid Antibody Syndrome

Libman-Sacks Endocarditis (LSE) is a form of nonbacterial thrombotic endocarditis (NBTE) occurring in the set­ting of hypercoagulable states like solid organ malignancies, systemic lupus erythematosus (SLE) and primary or secondary antiphospholipid antibody syndrome (APLS).LSE is the most characteristic cardiac manifestation of SLE. Even though the incidence of clinically significant valve dysfunction and embolic phenomenon is low when it is associated with secondary APLS, risk for embolic cerebrovascular events is high.

We present a case of a 39-year-old female who admitted with a left sided ischemic stroke ultimately turned out to be having LSE secondary to SLE and APLS. This will demonstrate the importance of having a high degree of suspicion for the diagnosis of LSE and its etiology when evaluating a young patient with stroke.