Echocardiographic evaluation of patients with primary antiphospholipid syndrome

Background A third to hall of the patients with primary antiphospholipid sy ndrome have valve disease. Methods and Results The echocardiographic characteristics of primary antiph ospholipid syndrome were analyzed, and the utility of treatment with antico agulants and/or antiplatelet agents (acetylsalicylic acid) is examined with the use of transesophageal echocardiography in the evaluation of valvular lesions after year of therapy. Twenty-nine patients, 22 women and 7 men wit h average age of 35.4 years, were studied. Transesophageal echocardiography was performed on all patients before beginning anticoagulant and/or antipl atelet treatment. Valve lesions were found in 22 (75.9%) patients. Of these , of her cardiac abnormalities were found in 3 cases, myocardial infarction in 2, and atrial septal defect in. In 7 (24.1%) cases, no valvular abnorma lity was detected, although in 1 of these, alterations in left ventricular segmental wall movement secondary to myocardial infarction were found. One year after initiation of anticoagulant and/or antiplatelet therapy, it was possible to perform transesophageal echocardiograms on 13 patients. No modi fication of valve lesions was Found in 6 (46.2%) cases; new lesions had app eared in the remaining 7 (53.8%) as well as left ventricular apical akinesi s in 1 case. Conclusions These results indicate that the predominant heart lesion in pri mary antiphospholipid syndrome is valvular; anticoagulant and/or antiplatel et treatment does not diminish the noninfective valve lesions, and on occas ion this entity may be associated with myocardial infarction despite angiog raphically normal coronary arteries.