Transesophageal echocardiographic demonstration of resolution of mitral vegetations after warfarin in a patient with the primary antiphospholipid syndrome

Skyrme-Jones, R. Andrew P., Wardrop, Charles A. J., Wiles, Charles Mark and Fraser, Alan Gordon 1995. Transesophageal echocardiographic demonstration of resolution of mitral vegetations after warfarin in a patient with the primary antiphospholipid syndrome. Journal of the American Society of Echocardiography 8 (3) , pp. 251-256. 10.1016/s0894-7317(05)80034-3

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Abstract

A 16-year-old girl with multiple cerebral infarcts was reported to have a normal transthoracic echocardiogram, but transesophageal echocardiography revealed vegetations on the atrial surfaces of both mitral leaflets at their line of closure. Blood cultures were negative, and prolonged treatment with intravenous antibiotics produced no echocardiographic improvement in the appearance of the vegetations. A diagnosis of primary antiphospholipid syndrome was made subsequently, although test results for this condition had initially been normal. Serial transesophageal echocardiograms showed complete resolution of the vegetations but some persistent thickening of the mitral leaflets, after warfarin therapy for 9 months. We suggest that in patients with culture-negative endocardial vegetations, specific tests should be performed for the primary antiphospholipid syndrome and a therapeutic trial of warfarin should be undertaken before contemplating heart surgery.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Subjects:	R Medicine > R Medicine (General) R Medicine > RZ Other systems of medicine
Publisher:	Elsevier
ISSN:	0894-7317
Last Modified:	28 Jun 2019 02:43
URI:	https://orca.cardiff.ac.uk/id/eprint/68673

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