Korean Circ J.  2016 May;46(3):425-428. 10.4070/kcj.2016.46.3.425.

Non-Bacterial Thrombotic Endocarditis in a Patient with Rheumatoid Arthritis

• Choi JH
• Park JE
• Kim JY
• Kang T

• KMID: 2344458
• DOI: http://doi.org/10.4070/kcj.2016.46.3.425

Abstract

Rheumatoid arthritis (RA) is frequently associated with various extra-joint complications. Although rare, thromboembolic complications are associated with high morbidity and mortality. We experienced a very rare case of nonbacterial thrombotic endocarditis (NBTE) and subsequent embolic stroke in a patient with RA. A 72-year-old male with a 15-year history of RA suddenly developed neurologic symptoms of vomiting and dizziness. Brain magnetic resonance imaging revealed recently developed multiple cerebellar and cerebral lacunar infarctions. Echocardiography showed a pulsating mitral valve vegetation involving the posterior cusp of the mitral valve leaflet, which was confirmed as NBTE. Immediate anti-coagulation therapy was started. The NBTE lesion disappeared in follow-up echocardiography after 4 weeks of anti-coagulation treatment.

Keyword

Endocarditis, non-infective; Arthritis, rheumatoid; Mitral valve

MeSH Terms

Aged
Arthritis, Rheumatoid*
Brain
Dizziness
Echocardiography
Endocarditis
Endocarditis, Non-Infective*
Follow-Up Studies
Humans
Magnetic Resonance Imaging
Male
Mitral Valve
Mortality
Neurologic Manifestations
Stroke
Stroke, Lacunar
Vomiting