Non-bacterial thrombotic endocarditis with cryptogenic stroke

Abstract

Negative blood culture and pathological findings are helpful to diagnose non-bacterial thrombotic endocarditis. The treatment strategy, including lifelong anticoagulation or surgery, should be individualized based on patients' underlying diseases.

Keywords: cryptogenic stroke; lifelong anticoagulation; non‐bacterial thrombotic endocarditis; surgery; transesophageal echocardiography.

FIGURE 1

A polypoid lesion on the non‐coronary cusp (yellow arrow) with a calcified aortic valve on transesophageal echocardiography. LA, left atrium; RA, right atrium; RV, right ventricle

FIGURE 2

The sample findings of hematoxylin and eosin staining (A–C). The sample consisted of an acidophilic amorphous structure (B, white arrow), suggesting thrombus and a slight amount of fibrous tissue (C, black arrow) with calcification (B, C, yellow arrows). Additionally, calcification of the aortic valve without inflammation was also seen (D, yellow arrowhead). These excluded Lambl's excrescences and papillary fibroelastoma and suggested non‐bacterial thrombotic endocarditis with calcification