Echocardiography in nonbacterial thrombotic endocarditis: From autopsy to clinical entity

Bacteria-free verrucae, frequently termed "nonbacterial thrombotic endocard itis," have been recognized in autoimmune disorders as well as in neoplasti c diseases. The antemortem diagnosis of nonbacterial thrombotic endocarditi s is rare, and most existing data result from postmortem examinations. In 3 prospective echocardiographic studies we found typical cardiac valvular le sions in patients with primary antiphospholipid syndrome, myeloproliferativ e disorders, acid solid malignant tumors. Cardiac lesions associated with t hese 3 different entities had common echocardiographic appearance and corre lated positively with thromboembolic events. The possibility of common path ogenesis is suggested, and clinical significance is discussed.