The main clinical criterion of antiphospholipid syndrome (APS) is venous or arterial thrombosis. Its less-known clinical manifestation is the affection of the heart and heart valves. The authors have described simultaneous involvement of the brain and heart within primary APS that was manifested clinically with cerebral infarction developed due to cardiac embolization in aseptic (noninfectious) endocarditis of the mitral valve. Abnormalities of cardiac valves are found in as much as one-third of patients with primary APS. Valvulopathy is presented by thickening, adhesions, valve rigidity and non-bacterial vegetations. However, these lesions may be evaluated by differential diagnostics as infectious endocarditis and, thus, treated incorrectly. In aseptic endocarditis, developed at APS, anticoagulant therapy is highly effective in the secondary prevention of systemic, especially cerebral, embolization. The aim of this report is to show the possibility of less frequent cause of cerebral ischemia such as non-bacterial endocarditis in APS. The examination of coagulation cascade, or laboratory rheumatological screening and transesophageal echocardiography (TEE) have been considered an essential component of an investigating standard in patients by the age of 60 years or at cryptogenic ictus.

        Key words: antiphospholipid syndrome, vascular thrombosis, non-infectious endocarditis, transesophageal echocardiography