Libman–Sacks endocarditis (LSE) is a cardiac manifestation of systemic lupus erythematosus and antiphospholipid syndrome and is characterized by non-bacterial verrucous vegetations with thrombogenic potential, causing stenosis and/or regurgitation in left heart predominantly, which can be asymptomatic in most of the cases but in the acute form it may present an infective form (pseudoinfective endocarditis) and complicate diagnosis and treatment. We present a case of aortic and tricuspid valve destruction due to Libman-Sacks endocarditis in a patient with antiphospholipid syndrome requiring surgical treatment by aortic and tricuspid valve replacement.