Nonbacterial thrombotic endocarditis

Publication date: Available online 18 September 2019Source: Revista Portuguesa de Cardiologia (English Edition)Author(s): Isabel Durães Campos, Ana Rita Marques, Luciana Sousa, Sara Fonseca, Cátia Oliveira, Catarina Vieira, Isabel Apolinário, Ilídio BrandãoAbstractAn 83-year-old woman with a 10-year history of rheumatoid arthritis was admitted for urinary tract infection with exacerbation of chronic kidney disease and decompensated heart failure of unknown etiology. Transesophageal echocardiography (TEE) showed a vegetation involving the posterior mitral valve leaflet, and a hypothesis of infective endocarditis was proposed. Empirical antibiotic therapy was initiated. TEE was repeated after antibiotic therapy, and showed persistence of the original vegetation and revealed the presence of another, smaller vegetation. Clinical investigation revealed no infectious process, and so a diagnosis of nonbacterial thrombotic endocarditis (NBTE) was established. Anticoagulant therapy was started immediately. The NBTE lesion had disappeared on the follow-up echocardiogram two months after anticoagulant therapy.ResumoDoente de 83 anos, sexo feminino, com antecedentes de artrite reumatoide há 10 anos, foi internada por infecção do trato urinário com lesão renal aguda em doença renal crónica e insuficiência cardíaca descompensada de etiologia não esclarecida. Ecocardiograma transesofágico (ETE) com vegetação apensa ao folheto posterior da válvula mitral, colocando-se a hi...
Source: Revista Portuguesa de Cardiologia - Category: Cardiology Source Type: research