ABSTRACT
A variety of cardiac manifestations has been found in association with antiphospholipid antibodies (aPL), both in patients with systemic lupus erythematosus (SLE) and with the "primary" antiphospholipid syndrome (PAPS). Several cases of myocardial infarction have been documented both in patients with APS associated with SLE and in the "primary" APS. The improved survival of SLE patients may have altered the natural history of the cardiac involvement, allowing the emergence of chronic valvular dysfunction as the end stage of Libman-Sacks endocarditis. Although some patients with myocardial infarction and aPL presented with angina before or after the acute infarction, isolated unstable angina has been reported occasionally in patients with the APS. As in patients with acute cardiomyopathy small vessel occlusive disease may be responsible. K. E. Morton et al., has also reported a very powerful association of aCL with coronary artery bypass graft occlusion in a placebo group not treated with aspirin.
