Non-bacterial thrombotic endocarditis historical perspective

non-bacterial thrombotic endocarditis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Homa Najafi, M.D.[2]

Historical Perspective

Discovery

• There is limited information about the historical perspective of [disease name].

OR

• [Disease name] was first discovered by [name of scientist], a [nationality + occupation], in [year]/during/following [event].

• The association between [important risk factor/cause] and [disease name] was made in/during [year/event].
• In [year], [scientist] was the first to discover the association between [risk factor] and the development of [disease name].
• In [year], [gene] mutations were first implicated in the pathogenesis of [disease name].

Nonbacterial thrombotic endocarditis (NBTE) was 6rst described, in 1668, by Zeigler,’ who introduced the term thromboendocarditis to describe deposition of 6brin on cardiac valves. He considered the lesions to be bland thrombi deposited from blood on normal or superticially degenerated valves. It was later referred to as cachectic (marantic) endocarditis2 and then, in 1923, by Libman3 as “terminal type” (terminal endocarditis) which was most frequently found on the left side of the heart and characteristically lacked Aschoff bodies. Gross and Friedberg provided a more extensive description in 1936, using the term “nonbacterial thrombotic endocarditis.” Allen and Sirotas used the term “degenerative verrucous endocardiosis” and believed that the origin of the vegetation was valvulogenic rather than thrombogenic in nature, consisting primarily of swollen, degenerated collagen of the valves. This entity had been virtually ignored in the literature for 10 years, until 1954, when Angrist and Marquis@ presented evidence that this lesion frequently resulted in systemic emboli. In 1957, MacDonald and Robbins’ confirmed this finding and emphasized the clinical importance of emboli from these nonbacterial valvular vegetations. They also noted that NBTE was not found solely in patients with carcinoma or debilitating diseases and divided their cases into two groups: one in which embolism was clearly evident clinically and a second group in which embolism was occult. With the advent of new noninvasive modalities, there is currently greater potential for the premortem diagnosis of this disease entity.

Famous Cases

The following are a few famous cases of [disease name]: