Intra-Left Ventricule Thrombus in Behcet's Disease About 3 Cases

Introduction: Behçet's disease (BD) is a systemic vasculitis with a triad of oral and genital aphthosis and hypopyon uveitis, potentially accompanied by various systemic manifestations. While venous thrombosis is common, cardiac involvement, including intracardiac thrombi (ICT), is rare. The occurrence of left ventricular thrombi (LVT) in BD presents significant diagnostic and therapeutic challenges. Observations and Patients: We present three cases of BD with LV thrombus diagnosed at the Cardiology Department of University Hospital Ibn Rochd, Casablanca. The patients, aged 28 to 54 years, included two men and one woman. All had a history of BD symptoms before cardiac issues were identified. Clinical examinations revealed oral and genital aphthae, skin lesions, and positive Pathergy tests in one patient. Cardiac imaging confirmed left ventricular thrombi in all patients, with varying degrees of left ventricular ejection fraction (LVEF) impairment. Treatment included corticosteroids, immunosuppressants, anticoagulants, and heart failure management. Two patients showed improvement, while one patient with severe multi-organ involvement unfortunately died. Discussion: Cardiac involvement in BD is rare, and ICTs are exceptional. These thrombi, typically adherent to the wall and less emboligenic are discovered primarily through echocardiography. The treatment is not standardized but generally involves anticoagulants, corticosteroids, and immunosuppressants. Early detection and treatment are crucial, as the prognosis is significantly influenced by cardiovascular involvement. Conclusion: ICT in BD, while rare, is a serious complication that requires careful diagnostic and therapeutic management. Echocardiography should be considered in the evaluation of BD, even in the absence of cardiac symptoms, due to the potential severity of cardiovascular involvement.