Lambl's Excrescences: A Brief Overview of Morphology, Clinical Implications, and Management

Author(s): Md Ripon Ahammed, Fariha Noor Ananya

Lambl's excrescences are thin, thread-like projections that develop on heart valves, primarily at points where the valves close. First documented in 1856 by Lambl, these formations consist of fibrous tissue cores with a mucopolysaccharide matrix. Lambl’s excrescences are commonly found on aortic, mitral, pulmonary, and tricuspid valves, both native and prosthetic and occasionally on the endocardial surface of the interatrial septum and papillary muscles. Advanced cardiac imaging techniques, particularly transesophageal echocardiography, have increased the detection of these structures. While lambl’s excrescences are often asymptomatic and incidentally discovered, studies have investigated the clinical significance of these with embolic strokes and other cardiovascular events, yielding mixed results. Treatment varies from monitoring and medical management with antiplatelet or anticoagulation therapy to surgical excision in recurrent or symptomatic cases.