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Case Reports
. 2022 May 20;6(5):205-208.
doi: 10.1016/j.case.2022.04.002. eCollection 2022 Jul.

Severe Aortic Regurgitation by Nonbacterial Thrombotic Endocarditis Treated with Anticoagulation Therapy

Azusa Murata  1 , Nobuyuki Kagiyama  1   2 , Sakiko Miyazaki  1 , Tomohiro Kaneko  1 , Naoko Shimada  3 , Youichiro Mitsuishi  3 , Tohru Minamino  1
Affiliations
Case Reports

Severe Aortic Regurgitation by Nonbacterial Thrombotic Endocarditis Treated with Anticoagulation Therapy

Azusa Murata et al. CASE (Phila). .
No abstract available

Keywords: Adenocarcinoma; Anticoagulation therapy; Cerebral embolization; Marantic endocarditis; Nonbacterial thrombotic endocarditis.

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Figures

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Graphical abstract
Figure 1
Figure 1
Brain MRI at diagnosis. Small cerebral infarctions (yellow arrows) in multiple cerebral regions are shown.
Figure 2
Figure 2
Chest computed tomography at diagnosis. Diffuse microthrombi (yellow arrows) in peripheral pulmonary arteries (A) and deep vein thrombosis (black arrow) in right lower extremity (B) are shown.
Figure 3
Figure 3
Follow-up transthoracic echocardiography. Zoomed parasternal short-axis view (A) and zoomed parasternal long-axis view of the aortic valve showing thickened aortic valve leaflets, predominately of the noncoronary cusp (arrow) (B). Zoomed parasternal long-axis view of the aortic valve with color Doppler imaging shows the AR jet with flow convergence noted on the aortic side of the aortic valve (C); AR vena contracta = 9.8 mm; AR jet/left ventricular outflow tract ratio = 55%. Zoomed apical long-axis view of aortic valve with color Doppler imaging showing severe AR (D).
Figure 4
Figure 4
Transesophageal echocardiography. Short-axis (A) and long-axis (C) images of the aortic valve showing low-echoic, irregularly shaped masses adherent to the coapting edges of all three aortic leaflets. The maximum size was 16.0 × 6.7 mm (width × height). Severe AR is noted on the corresponding color Doppler images (B, D).
Figure 5
Figure 5
Transthoracic echocardiography after anticoagulation therapy. The parasternal long-axis view (A) and the parasternal short-axis view (C) of the aortic valve show resolution of the echogenic masses. The color Doppler image from the parasternal long-axis view shows a dramatic reduction in AR severity to mild (B).
Figure 6
Figure 6
Chest X-rays before and after chemotherapy. Comparison of chest X-rays (A) before and (B) after chemotherapy displays notable shrinkage of the right hilar lymph nodes and right lower lobe mass shadow (arrows in A).
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