Connective Tissue Diseases
Systemic lupus erythematosus
Antiphospholipid antibody syndrome
Ankylosing spondylitis
Rheumatoid arthritis
Polymyositis and dermatomyositis
Mixed connective tissue disease

Cardiac Diseases in Pts with SLE
Pericardial disease
Valvular disease
 Fibrin deposits (Libman-Sacks)
 Fibrous thickening of leaflets and chordae
 Valvular regurgitation and/ or stenosis
 Infective endocarditis
Coronary artery diseases
Myocardial diseae

Valvular Disease Associated with SLE
Valve masses or Libman-Sacks vegetation
Leaflet thickening
Valvular regurgitation
Valvular stenosis

Libman-Sacks Vegetation
Cauliflower-like or flat, red multiple spreading masses of 2 – 4 mm in diameter present on the free margins or line of closure of the heart valve

Aortic Root Disease and Valve Disease Associated with Ankylosing Spondylitis
 The inflammatory process predominantly of the adventitia and intima of the aortic root results in a fibroblastic reparative response and vascularized fibrous tissue thickening
Aortic valvulitis
 Cusp thickening and retraction
 Thickening of the aorto-mitral junction or subaortic bump
 Proximal aortitis leading to aortic root thickening and dilation
 Aortic and mitral regurgitation..

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