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February 13, 1995

Dissolution of Intracardiac Mass Lesions in the Primary Antiphospholipid Antibody Syndrome

Author Affiliations

From the University of Connecticut School of Medicine, Farmington (Dr O'Neill); Division of Rheumatology, Yale University School of Medicine, New Haven, Conn (Drs Magaldi and Greco); and Departments of Cardiology (Dr Dobkins) and Rheumatology (Dr Greco), St Mary's Hospital, Waterbury, Conn.

Arch Intern Med. 1995;155(3):325-327. doi:10.1001/archinte.1995.00430030123014

The antiphospholipid antibody syndrome has numerous cardiac manifestations, including valvular thickening, insufficiency, and mass lesions. The mass lesions may be confused with atrial myxomas and other vegetations, sometimes necessitating a surgical diagnosis. There are no prospective studies on treatment or follow-up of intracardiac lesions in antiphospholipid antibody syndrome. We prospectively followed up three patients with antiphospholipid antibody syndrome for intracardiac lesions (one atrial and two mitral valve masses) complicated by systemic embolization. Anticoagulation led to complete resolution of the masses in 6 weeks to 3 months. We propose that initial treatment of an intracardiac lesion in patients with antiphospholipid antibody syndrome should be a trial of systemic anticoagulation before surgical intervention.

(Arch Intern Med. 1995;155:325-327)