A Curious Case of Multiple Intracardiac Masses: Antiphospholipid Syndrome Manifesting as Multiple Intracardiac Thrombi

Abstract

Antiphospholipid syndrome (APS) is a multisystem autoimmune disease characterized by acquired hypercoagulability, recurrent pregnancy loss, and elevated levels of antiphospholipid antibodies. The common cardiovascular manifestations include valvulopathy, coronary artery disease (CAD), myocardial dysfunction, cardiac thrombi, pulmonary thromboembolism, and pulmonary hypertension. Herein we present a case who presented with stroke with incidentally detected multiple cardiac lesions on echocardiography suspicious for mass. Cardiac magnetic resonance (CMR) was able to accurately characterize these lesions as cardiac thrombi, which were subsequently confirmed by endomyocardial biopsy. In this article, the case we discussed, highlights the importance of CMR in accurately characterizing the suspected mass lesion in echocardiography, thus arriving at an accurate diagnosis that changed patient management altogether.

Keywords

• antiphospholipid antibody syndrome
• cardiac mri
• cardiac thrombus