Abstract
Negative blood culture and pathological findings are helpful to diagnose non‐bacterial thrombotic endocarditis. The treatment strategy, including lifelong anticoagulation or surgery, should be individualized based on patients' underlying diseases.
Highlights
An 83-year-old Japanese woman with diabetes presented with dyspnea on exertion due to severe aortic stenosis and a polypoid lesion on transesophageal echocardiography (Figure 1)
Non-bacterial thrombotic endocarditis is a type of noninfective endocarditis commonly associated with pre- existing comorbidities like diabetes (40%) and malignancy (59%), especially in patients over 70 years.[1]
Anticoagulation may decrease stroke risk; surgery should be considered in severe valvular disease cases or recurrent strokes despite anticoagulation.[2]
Summary
Non-bacterial thrombotic endocarditis is a type of noninfective endocarditis commonly associated with pre- existing comorbidities like diabetes (40%) and malignancy (59%), especially in patients over 70 years.[1]. An 83-year-old Japanese woman with diabetes presented with dyspnea on exertion due to severe aortic stenosis and a polypoid lesion on transesophageal echocardiography (Figure 1). Laboratory findings were as follows: white blood count, 5700/μl with 69.0% neutrophils; C-reactive protein, 0.56 mg/dl; hemoglobin A1c, 6.4%; and antinuclear antibody, negative. Three sets of blood cultures were negative.
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