NBTE and NIE

Q) Which endocarditis is more prone to cause dislodged? 

A) infective endocarditis 
B) non-bacterial thrombotic endocarditis (NBTE) 


 Answer: B

This is due to the fact that vegetations in NBTE (popularly know as Libman-Sacks endocarditis) can get easily dislodged as there is a very little inflammatory reaction at the site of attachment. Subsequently, this can lead to massive cerebral infarction. In systemic lupus erythematosus (SLE) the odds ratio for such event is as high as 13.4 if vegetation is present.

#cardiology
#rheumatology
#infectious-diseaes


Reference:

Roldan CA, Sibbitt WL Jr, Qualls CR, et al. Libman-Sacks endocarditis and embolic cerebrovascular disease. JACC Cardiovasc Imaging 2013; 6:973.