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06:01
A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
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Nonbacterial thrombotic endocarditis
Isabel Durães Campos1, Ana Rita Marques1, Luciana Sousa1
1Serviço de Cardiologia e Medicina Interna, Hospital de Braga, Braga, Portugal.
Revista Portuguesa De Cardiologia
|September 17, 2019
Summary
Nonbacterial thrombotic endocarditis (NBTE) can mimic infective endocarditis. Prompt anticoagulant therapy effectively resolved NBTE vegetations in a patient with rheumatoid arthritis and heart failure.
Area of Science:
- Cardiology
- Rheumatology
- Infectious Diseases
Background:
- Rheumatoid arthritis (RA) is a chronic autoimmune disease.
- Comorbidities like chronic kidney disease (CKD) and heart failure (HF) are common in RA patients.
- Infective endocarditis (IE) is a serious complication that can present with vegetations on heart valves.
Observation:
- An 83-year-old female with RA presented with UTI, CKD exacerbation, and decompensated HF.
- Transesophageal echocardiography (TEE) revealed mitral valve vegetations, initially suggesting IE.
- Despite empirical antibiotic treatment, vegetations persisted, prompting further investigation.
Findings:
- Clinical and laboratory findings excluded an infectious process.
- Diagnosis of nonbacterial thrombotic endocarditis (NBTE) was established.
- NBTE vegetations resolved completely after two months of anticoagulant therapy.
Implications:
- NBTE should be considered in the differential diagnosis of cardiac vegetations, especially in patients with autoimmune conditions.
- Early diagnosis and initiation of anticoagulant therapy are crucial for managing NBTE.
- This case highlights the importance of a comprehensive diagnostic approach to cardiac vegetations.
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