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Nonbacterial thrombotic endocarditis: a review.

J A Lopez, R S Ross, M C Fishbein

    American Heart Journal
    |March 1, 1987
    PubMed
    Summary
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    Non-bacterial thrombotic endocarditis (NBTE) is rarely diagnosed before death. Clinical suspicion in patients with underlying diseases and embolization, confirmed by echocardiography, aids diagnosis and heparin therapy may prevent embolization.

    Area of Science:

    • Cardiology
    • Pathology
    • Internal Medicine

    Background:

    • Non-bacterial thrombotic endocarditis (NBTE) is a rare condition.
    • It is often associated with underlying systemic diseases like malignancy or disseminated intravascular coagulation (DIC).
    • NBTE poses diagnostic challenges due to its infrequent antemortem identification.

    Purpose of the Study:

    • To review the historical aspects, epidemiology, and pathogenesis of NBTE.
    • To emphasize clinicopathologic findings and diagnostic approaches.
    • To discuss therapeutic strategies for NBTE.

    Main Methods:

    • Review of existing literature on NBTE.
    • Discussion of clinicopathologic findings.
    • Emphasis on diagnostic modalities and therapeutic interventions.

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    Main Results:

    • NBTE is infrequently diagnosed antemortem.
    • Clinical suspicion arises from underlying conditions and embolic phenomena.
    • Systemic infection must be ruled out.
    • Two-dimensional echocardiography is a key diagnostic tool.

    Conclusions:

    • Early diagnosis of NBTE requires high clinical suspicion.
    • Underlying conditions and embolic evidence are crucial indicators.
    • Two-dimensional echocardiography facilitates diagnosis.
    • Heparin anticoagulation may prevent embolization in NBTE patients.