What is the primary characteristic of Libman-Sacks endocarditis?

Libman-Sacks endocarditis is primarily characterized by the presence of small vegetations that are associated with systemic lupus erythematosus (SLE). These vegetations typically form on both the atrial and ventricular sides of the heart valves, distinguishing them from other forms of endocarditis that may present with larger, more destructive vegetations.

The association with lupus is significant, as Libman-Sacks endocarditis is considered a non-infectious type of endocarditis related to the autoimmune process of SLE. This condition is not caused by an infectious agent but rather results from immune-mediated damage, which leads to the formation of sterile vegetations composed mainly of fibrin and immune complexes.

In contrast to other types of endocarditis, such as infective endocarditis which features larger vegetations that can cause significant valve destruction and ulceration, Libman-Sacks vegetations are often smaller and less likely to lead to valve failure or severe clinical consequences. This key distinction underscores the essence of Libman-Sacks endocarditis and its association with systemic lupus erythematosus.