Non-bacterial thrombotic endocarditis history and symptoms: Difference between revisions

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__NOTOC__
__NOTOC__
{{Non-bacterial thrombotic endocarditis}}
{{Non-bacterial thrombotic endocarditis}}
{{CMG}}; {{AE}}{{Homa}}
{{CMG}}; {{AE}}{{Aisha}}
==Overview==
==Overview==
The majority of patients with [disease name] are asymptomatic.
The majority of patients with non-bacterial thrombotic endocarditis are asymptomatic. Systemic embolism of the brain, liver, or spleen is a common initial clinical manifestation of NBTE, and occur in more than half of patients. Patients with NBTE may have a positive history of malignancy, disseminated intravascular coagulation, antiphospholipid syndrome, autoimmune disease such as systemic lupus erythematosus, e.t.c
 
OR
 
The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. Common symptoms of [disease] include [symptom 1], [symptom 2], and [symptom 3]. Less common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].


==History and Symptoms==
==History and Symptoms==
*The majority of patients with [disease name] are asymptomatic.
*The majority of patients with non-bacterial thrombotic endocarditis are asymptomatic<ref name="urlNonbacterial Thrombotic Endocarditis in Cancer Patients: Pathogenesis, Diagnosis, and Treatment - el‐Shami - 2007 - The Oncologist - Wiley Online Library">{{cite web |url=+https://doi.org/10.1634/theoncologist.12-5-518 |title=Nonbacterial Thrombotic Endocarditis in Cancer Patients: Pathogenesis, Diagnosis, and Treatment - el‐Shami - 2007 - The Oncologist - Wiley Online Library |format= |work= |accessdate=}}</ref>.
OR
*Systemic embolism of the brain, liver, or spleen is a common initial clinical manifestation of NBTE, and occur in more than half of patients<ref name="pmid9217593">{{cite journal |vauthors=Edoute Y, Haim N, Rinkevich D, Brenner B, Reisner SA |title=Cardiac valvular vegetations in cancer patients: a prospective echocardiographic study of 200 patients |journal=Am. J. Med. |volume=102 |issue=3 |pages=252–8 |date=March 1997 |pmid=9217593 |doi=10.1016/S0002-9343(96)00457-3 |url=}}</ref><ref name="pmid17522239">{{cite journal |vauthors=el-Shami K, Griffiths E, Streiff M |title=Nonbacterial thrombotic endocarditis in cancer patients: pathogenesis, diagnosis, and treatment |journal=Oncologist |volume=12 |issue=5 |pages=518–23 |date=May 2007 |pmid=17522239 |doi=10.1634/theoncologist.12-5-518 |url=}}</ref><ref name="urlInfective endocarditis | The BMJ">{{cite web |url=https://www.bmj.com/content/333/7563/334 |title=Infective endocarditis &#124; The BMJ |format= |work= |accessdate=}}</ref>.
*The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
*The most common presentation of NBTE is a sudden stroke<ref name="pmid3965856">{{cite journal |vauthors=Graus F, Rogers LR, Posner JB |title=Cerebrovascular complications in patients with cancer |journal=Medicine (Baltimore) |volume=64 |issue=1 |pages=16–35 |date=January 1985 |pmid=3965856 |doi=10.1097/00005792-198501000-00002 |url=}}</ref>.
*Symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. 
*About 50% of patients with NBTE present with new or a change in existing cardiac murmurs.
*Murmurs are usually non-specific systolic murmurs commonly located in the left lower sternal border<ref name="pmid4682494">{{cite journal |vauthors=Rosen P, Armstrong D |title=Nonbacterial thrombotic endocarditis in patients with malignant neoplastic diseases |journal=Am. J. Med. |volume=54 |issue=1 |pages=23–9 |date=January 1973 |pmid=4682494 |doi=10.1016/0002-9343(73)90079-x |url=}}</ref>.
*Valvular deficiency or heart failure is an uncommon initial presentation<ref name="pmid20397972">{{cite journal |vauthors=Mazokopakis EE, Syros PK, Starakis IK |title=Nonbacterial thrombotic endocarditis (marantic endocarditis) in cancer patients |journal=Cardiovasc Hematol Disord Drug Targets |volume=10 |issue=2 |pages=84–6 |date=June 2010 |pmid=20397972 |doi=10.2174/187152910791292484 |url=}}</ref>.
===History===
===History===
Patients with [disease name]] may have a positive history of:
Patients with NBTE may have a positive history of<ref name="urlNonbacterial Thrombotic Endocarditis in Cancer Patients: Pathogenesis, Diagnosis, and Treatment - el‐Shami - 2007 - The Oncologist - Wiley Online Library">{{cite web |url=https://theoncologist.onlinelibrary.wiley.com/doi/full/10.1634/theoncologist.12-5-518 |title=Nonbacterial Thrombotic Endocarditis in Cancer Patients: Pathogenesis, Diagnosis, and Treatment - el‐Shami - 2007 - The Oncologist - Wiley Online Library |format= |work= |accessdate=}}</ref><ref name="urlLibman-Sacks Endocarditis Clinical Presentation: History, Physical Examination">{{cite web |url=https://emedicine.medscape.com/article/155230-clinical |title=Libman-Sacks Endocarditis Clinical Presentation: History, Physical Examination |format= |work= |accessdate=}}</ref><ref name="urlNon-bacterial Thrombotic Endocarditis | IntechOpen">{{cite web |url=https://www.intechopen.com/books/infective-endocarditis/non-bacterial-thrombotic-endocarditis |title=Non-bacterial Thrombotic Endocarditis &#124; IntechOpen |format= |work= |accessdate=}}</ref>;
*[History finding 1]
*Malignancy
*[History finding 2]
*Disseminated intravascular coagulation
*[History finding 3]
*Antiphospholipid syndrome
*Autoimmune disease such as systemic lupus erythematosus


===Common Symptoms===
===Common Symptoms===
Common symptoms of [disease] include:
In alphabetical order, some of the common manifestations and symptoms of NTBE include:
*[Symptom 1]
*Signs of '''cerebrovascular embolism''' i.e<ref name="pmid3965856">{{cite journal |vauthors=Graus F, Rogers LR, Posner JB |title=Cerebrovascular complications in patients with cancer |journal=Medicine (Baltimore) |volume=64 |issue=1 |pages=16–35 |date=January 1985 |pmid=3965856 |doi=10.1097/00005792-198501000-00002 |url=}}</ref>;
*[Symptom 2]
**Amnesia
*[Symptom 3]
**Delirium
**Dysphagia
**Dysphasia
**Dysarthria
**Localized/diffuse weakness
**Localized/diffuse numbness
**Psychomotor agitation
**Seizures
**Vision loss
 
*Signs of '''heart failure secondary to defective valves''' i.e<ref name="pmid20397972">{{cite journal |vauthors=Mazokopakis EE, Syros PK, Starakis IK |title=Nonbacterial thrombotic endocarditis (marantic endocarditis) in cancer patients |journal=Cardiovasc Hematol Disord Drug Targets |volume=10 |issue=2 |pages=84–6 |date=June 2010 |pmid=20397972 |doi=10.2174/187152910791292484 |url=}}</ref>;
**Chest pain
**Dyspnea
**Lethargy
**Orthopnea
**Paroxysmal nocturnal dyspnea
**Peripheral edema
 
*Symptoms due to underlying '''systemic lupus erythematosus'''<ref name="urlLibman-Sacks Endocarditis Clinical Presentation: History, Physical Examination">{{cite web |url=https://emedicine.medscape.com/article/155230-clinical |title=Libman-Sacks Endocarditis Clinical Presentation: History, Physical Examination |format= |work= |accessdate=}}</ref>;
**Arthritis
**Hematuria
**Rash
**Sweating
**Fatigue
 
*Signs of '''systemic thromboembolism''' i.e<ref>Barry WE, Scarpelli D, Nonbacterial thrombotic endocarditis. A clinicopathologic study. Arch Neurol Med. 1962; 109: 79– 84</ref><ref name="pmid1259640">{{cite journal |vauthors=Kooiker JC, MacLean JM, Sumi SM |title=Cerebral embolism, marantic endocarditis, and cancer |journal=Arch. Neurol. |volume=33 |issue=4 |pages=260–4 |date=April 1976 |pmid=1259640 |doi=10.1001/archneur.1976.00500040044006 |url=}}</ref><ref name="pmid6837399">{{cite journal |vauthors=Miksanek T |title=Nonbacterial thrombotic endocarditis |journal=Am Fam Physician |volume=27 |issue=4 |pages=177–9 |date=April 1983 |pmid=6837399 |doi= |url=}}</ref>;
**Acute abdominal syndromes;
***Flank pain due to kidney infarction
***Nausea
***Pain
***Vomiting
**Raynaud's phenomenon due to embolization to the skin


===Less Common Symptoms===
===Less Common Symptoms===
Less common symptoms of [disease name] include  
In alphabetical order, some of the less common manifestations and symptoms of NBTE include;
*[Symptom 1]
*Secondary infective endocarditis
*[Symptom 2]
**Chest pain
*[Symptom 3]
**Fever
**Night sweats
**Weightloss


==References==
==References==

Latest revision as of 21:50, 22 August 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aisha Adigun, B.Sc., M.D.[2]

Overview

The majority of patients with non-bacterial thrombotic endocarditis are asymptomatic. Systemic embolism of the brain, liver, or spleen is a common initial clinical manifestation of NBTE, and occur in more than half of patients. Patients with NBTE may have a positive history of malignancy, disseminated intravascular coagulation, antiphospholipid syndrome, autoimmune disease such as systemic lupus erythematosus, e.t.c

History and Symptoms

  • The majority of patients with non-bacterial thrombotic endocarditis are asymptomatic[1].
  • Systemic embolism of the brain, liver, or spleen is a common initial clinical manifestation of NBTE, and occur in more than half of patients[2][3][4].
  • The most common presentation of NBTE is a sudden stroke[5].
  • About 50% of patients with NBTE present with new or a change in existing cardiac murmurs.
  • Murmurs are usually non-specific systolic murmurs commonly located in the left lower sternal border[6].
  • Valvular deficiency or heart failure is an uncommon initial presentation[7].

History

Patients with NBTE may have a positive history of[1][8][9];

  • Malignancy
  • Disseminated intravascular coagulation
  • Antiphospholipid syndrome
  • Autoimmune disease such as systemic lupus erythematosus

Common Symptoms

In alphabetical order, some of the common manifestations and symptoms of NTBE include:

  • Signs of cerebrovascular embolism i.e[5];
    • Amnesia
    • Delirium
    • Dysphagia
    • Dysphasia
    • Dysarthria
    • Localized/diffuse weakness
    • Localized/diffuse numbness
    • Psychomotor agitation
    • Seizures
    • Vision loss
  • Signs of heart failure secondary to defective valves i.e[7];
    • Chest pain
    • Dyspnea
    • Lethargy
    • Orthopnea
    • Paroxysmal nocturnal dyspnea
    • Peripheral edema
  • Symptoms due to underlying systemic lupus erythematosus[8];
    • Arthritis
    • Hematuria
    • Rash
    • Sweating
    • Fatigue
  • Signs of systemic thromboembolism i.e[10][11][12];
    • Acute abdominal syndromes;
      • Flank pain due to kidney infarction
      • Nausea
      • Pain
      • Vomiting
    • Raynaud's phenomenon due to embolization to the skin

Less Common Symptoms

In alphabetical order, some of the less common manifestations and symptoms of NBTE include;

  • Secondary infective endocarditis
    • Chest pain
    • Fever
    • Night sweats
    • Weightloss

References

  1. ↑ 1.0 1.1 [+https://doi.org/10.1634/theoncologist.12-5-518 "Nonbacterial Thrombotic Endocarditis in Cancer Patients: Pathogenesis, Diagnosis, and Treatment - el‐Shami - 2007 - The Oncologist - Wiley Online Library"] Check |url= value (help).
  2. ↑ Edoute Y, Haim N, Rinkevich D, Brenner B, Reisner SA (March 1997). "Cardiac valvular vegetations in cancer patients: a prospective echocardiographic study of 200 patients". Am. J. Med. 102 (3): 252–8. doi:10.1016/S0002-9343(96)00457-3. PMID 9217593.
  3. ↑ el-Shami K, Griffiths E, Streiff M (May 2007). "Nonbacterial thrombotic endocarditis in cancer patients: pathogenesis, diagnosis, and treatment". Oncologist. 12 (5): 518–23. doi:10.1634/theoncologist.12-5-518. PMID 17522239.
  4. ↑ "Infective endocarditis | The BMJ".
  5. ↑ 5.0 5.1 Graus F, Rogers LR, Posner JB (January 1985). "Cerebrovascular complications in patients with cancer". Medicine (Baltimore). 64 (1): 16–35. doi:10.1097/00005792-198501000-00002. PMID 3965856.
  6. ↑ Rosen P, Armstrong D (January 1973). "Nonbacterial thrombotic endocarditis in patients with malignant neoplastic diseases". Am. J. Med. 54 (1): 23–9. doi:10.1016/0002-9343(73)90079-x. PMID 4682494.
  7. ↑ 7.0 7.1 Mazokopakis EE, Syros PK, Starakis IK (June 2010). "Nonbacterial thrombotic endocarditis (marantic endocarditis) in cancer patients". Cardiovasc Hematol Disord Drug Targets. 10 (2): 84–6. doi:10.2174/187152910791292484. PMID 20397972.
  8. ↑ 8.0 8.1 "Libman-Sacks Endocarditis Clinical Presentation: History, Physical Examination".
  9. ↑ "Non-bacterial Thrombotic Endocarditis | IntechOpen".
  10. ↑ Barry WE, Scarpelli D, Nonbacterial thrombotic endocarditis. A clinicopathologic study. Arch Neurol Med. 1962; 109: 79– 84
  11. ↑ Kooiker JC, MacLean JM, Sumi SM (April 1976). "Cerebral embolism, marantic endocarditis, and cancer". Arch. Neurol. 33 (4): 260–4. doi:10.1001/archneur.1976.00500040044006. PMID 1259640.
  12. ↑ Miksanek T (April 1983). "Nonbacterial thrombotic endocarditis". Am Fam Physician. 27 (4): 177–9. PMID 6837399.

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