Complete resolution of a mitral valve vegetation with anticoagulation in seronegative antiphospholipid syndrome

Abstract

Antiphospholipid syndrome (APS) is a disorder characterized by recurrent venous or arterial thrombosis and/or fetal loss; involvement of cardiac valves is also seen. A seronegative variant has been described previously. We report a case of a woman with recurrent pregnancy loss, prior strokes, and a negative workup for known antiphospholipid antibodies. During her current pregnancy, she presented with acute stroke and mitral valve vegetation. Her workup for antiphospholipid syndrome and other thrombophilias remained negative even after the stroke. Her mitral valve vegetation resolved completely with aspirin, heparin, and warfarin. We believe this to be the first report of complete resolution of valvular vegetation with antiplatelet and anticoagulant therapy alone in a patient with seronegative antiphospholipid syndrome. Moreover, this appears to be the first report of stroke associated with this condition.

Atteinte cardiaque au cours du syndrome des antiphospholipides

“…Elle ne permet pas de prévenir la survenue de nouvelles lésions valvulaires. Il y a de rares cas de disparition des lésions valvulaires [56,57]. Une anticoagulation curative doit également être poursuivie sur le long terme des syndromes coronariens, éventuellement associée à une antiagré-gation plaquettaire en cas d'association à d'autres facteurs de risque cardiovasculaires [58].…”