Open in new tab Date . Event . Figure ....

Date	Event	Figure
15 years old	Diagnosis of antiphospholipid syndrome
18 years old	Diagnosis of systemic lupus erythematosus
	Steroid therapy initiated
55 years old (2019/2)	Dyspnoea on exertion appeared
	Echocardiography demonstrated severe mitral regurgitation (MR) with non-bacterial thromboendocarditis (NBTE)
	Anticoagulation therapy (warfarin potassium) started
55 years old (2019/10)	MR improved to mild grade
	NBTE had almost disappeared
58 years old (2022/11)	Echocardiography revealed mild MR and newonset mitral stenosis (MS)
59 years old (2023/11)	Hospitalization due to congestive heart failure
	Elevated brain natriuretic peptide level of 895 pg/mL
	Echocardiography showed severe MS and pulmonary hypertension
59 years old (2023/11)	Surgical mitral valve replacement (27-mm MITRIS RESILIA)

Date	Event	Figure
15 years old	Diagnosis of antiphospholipid syndrome
18 years old	Diagnosis of systemic lupus erythematosus
	Steroid therapy initiated
55 years old (2019/2)	Dyspnoea on exertion appeared
	Echocardiography demonstrated severe mitral regurgitation (MR) with non-bacterial thromboendocarditis (NBTE)
	Anticoagulation therapy (warfarin potassium) started
55 years old (2019/10)	MR improved to mild grade
	NBTE had almost disappeared
58 years old (2022/11)	Echocardiography revealed mild MR and newonset mitral stenosis (MS)
59 years old (2023/11)	Hospitalization due to congestive heart failure
	Elevated brain natriuretic peptide level of 895 pg/mL
	Echocardiography showed severe MS and pulmonary hypertension
59 years old (2023/11)	Surgical mitral valve replacement (27-mm MITRIS RESILIA)