What is marantic endocarditis?
The term nonbacterial thrombotic endocarditis (NBTE), or marantic endocarditis, refers to a spectrum of lesions ranging from microscopic aggregates of platelets to large vegetations on previously undamaged heart valves (most often aortic and mitral) in the absence of a bloodstream bacterial infection.
What causes marantic endocarditis?
Marantic endocarditis (a.k.a. non-bacterial thrombotic endocarditis or NBTE) occurs from deposition of thrombus and fibrinous material on the heart valves, most commonly the mitral valve. This is frequently associated with hypercoagulable states, adenocarcinomas and systemic lupus erythematosus.
What is the pathophysiology of endocarditis?
The pathophysiology of infective endocarditis comprises at least three critical elements: preparation of the cardiac valve for bacterial adherence, adhesion of circulating bacteria to the prepared valvular surface, and survival of the adherent bacteria on the surface, with propagation of the infected vegetation.
What causes Libman-Sacks endocarditis?
The most common valves to be affected are the aortic and mitral valves. Libman-Sacks endocarditis is associated with malignancies, other systemic diseases like systemic lupus erythematosus (SLE) and antiphospholipid antibody syndrome (APS).
What are vegetations in endocarditis?
In endocarditis, clumps made of germs and cell pieces form an abnormal mass in your heart. These clumps, called vegetations, can break loose and travel to your brain, lungs, abdominal organs, kidneys, or arms and legs.
How is marantic endocarditis treated?
Recommended treatment is therapeutic anticoagulation with unfractionated heparin or LMWH and treatment of the underlying cause [1, 3]. However, there have been no studies defining the optimal treatment of NBTE. Also, the benefit of heparin compared to warfarin in the treatment of NBTE has not been studied.
What is the most common causative agent of bacterial endocarditis?
Two kinds of bacteria cause most cases of bacterial endocarditis. These are staphylococci (staph) and streptococci (strep). You may be at increased risk for bacterial endocarditis if you have certain heart valve defects.
How is Libman-Sacks endocarditis diagnosed?
A diagnostic workup including chemistries, complete blood count, blood cultures, chest x-ray, and 2-D echocardiogram was performed to determine the etiology of her symptoms and differentiate between acute bacterial endocarditis and Libman–Sacks endocarditis.
How do you treat Libman-Sacks endocarditis?
No specific therapy is indicated for Libman-Sacks endocarditis. Manage heart failure due to valvular dysfunction according to usual guidelines. Medications may include vasodilators, beta blockers, diuretics, and digoxin.
What are heart vegetations?
How do vegetations form?
After the initial adherence, the bacteria become encased in a platelet/fibrin matrix termed “the vegetation.” Formation of the vegetation is likely initiated through release of tissue factor (thromboplastin) from damaged endothelium, causing platelet activation and aggregation and cleavage of fibrinogen to fibrin by …
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