ABDOL HAMID ZOKAEI, FERIDOUN SABZI, SARAH JOREIRAHMADI*
Imam Ali Heart Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
The anti phospholipids yndrome(APS) is a complex autoimmune disease that manifested by arterial and venous thrombosis,
repeated abortion, and presence of antiphospholipid antibodies. History of miscarriage, aortic regurgitation, right atrialthrombosis,
coronary artery disease, and post-operative chylous plural effusion is an exceedingly rare combination in systemic lupus erythematosus
(SLE) patients. We describe a case reportofa 35-year-old woman, admitted with a 10-year history of SLE with dyspnea, and typical
chest pain. The patient had history of arthralgia, fatigue, and intermittent fever that treated by corticosteroids for the past three
years. Subsequent transthoracic echocardiography (TTE) revealed the presence of a large mass in the right atrium that did not attach
to tricuspid apparatus. TTEalso revealed severe aortic regurgitation. Screening laboratory evaluation for thrombophilia confirmed
the diagnosis of secondary APS. The coronary angiography showed, sever three-vessel stenosis. Cardiac surgery with combined
coronary artery bypass grafting,aortic valve replacement and right atrial clot resection were performed. The post- operative course
was complicated withan exceptional complication of chylothorax which responded to a short period of corticosteroid therapy.
Histological examination of clot demonstrated it to be composed entirely of fresh thrombus.
Antiphospholipid syndrome, Lupuserythromatose, complication.