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Health Dictionary

Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Non-bacterial thrombotic endocarditis differential diagnosis

Introduction

Overview

Overview

Non-bacterial thrombotic endocarditis must be differentiated from other diseases that cause a new or changed heart murmur, multiple systemic emboli, +/-fever, such as infective endocarditis, degenerative valvular disease, and pulmonary infarction.

Differential Diagnosis

Differential Diagnosis

Non-bacterial thrombotic endocarditis must be differentiated from other diseases that cause a new or changed heart murmur, multiple systemic emboli, +/-fever, such as;[1]_Revista_Española_de_Cardiología_(English_Edition)-2|[2][3][4][5][6].

Diseases Diagnostic tests Physical Examination Symptoms Past medical history Other Findings
CT scan and MRI EKG Chest X-ray Tachypnea Tachycardia Fever Chest Pain Hemoptysis Dyspnea on Exertion Wheezing Chest Tenderness Nasalopharyngeal Ulceration Carotid Bruit
Pulmonary embolism
  • On CT angiography:
    • Intra-luminal filling defect
  • On MRI:
    • Narrowing of involved vessel
    • No contrast seen distal to obstruction
    • Polo-mint sign (partial filling defect surrounded by contrast)
 ✔ ✔ ✔ (Low grade) ✔ ✔ (In case of massive PE) ✔ – – – –
Infective Endocarditis
  • Goldberg’s criteria may aid in diagnosis of left ventricular dysfunction: (High specificity)
    • SV1 or SV2 + RV5 or RV6 ≥3.5 mV
    • Total QRS amplitude in each of the limb leads ≤0.8 mV
    • R/S ratio <1 in lead V4
 ✔ ✔ ✔ – – ✔ – – – –
Non-bacterial thrombotic endocarditis
  • ST elevation
  • PR depression
 ✔ ✔ ✔ (Low grade) ✔ (Relieved by sitting up and leaning forward) – ✔ – – – –
  • May be clinically classified into:
    • Acute (< 6 weeks)
    • Sub-acute (6 weeks – 6 months)
    • Chronic (> 6 months)
Libman Sack Endocarditis ✔ ✔ ✔ ✔ – ✔ ✔ – – –
Vasculitis

Homogeneous, circumferential vessel wall swelling

✔ ✔ ✔ ✔ ✔ ✔ – ✔ ✔ ✔
Fever of unknown origin (FUO) ✔ ✔ – – – ✔ ✔ – – –

Differentiating [Disease name] from other Diseases

[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].

OR

[Disease name] must be differentiated from [differential dx1], [differential dx2], and [differential dx3].

OR

As [disease name] manifests in a variety of clinical forms, differentiation must be established in accordance with the particular subtype. [Subtype name 1] must be differentiated from other diseases that cause [clinical feature 1], such as [differential dx1] and [differential dx2]. In contrast, [subtype name 2] must be differentiated from other diseases that cause [clinical feature 2], such as [differential dx3] and [differential dx4].

References

  1. ↑ “Libman-Sacks Endocarditis Differential Diagnoses”.
  2. _Revista_Española_de_Cardiología_(English_Edition)_2-0|↑ “Nonbacterial Thrombotic Endocarditis: Clinicopathologic Study of a Necropsy Series | Revista Española de Cardiología (English Edition)”.
  3. ↑ Lopez JA, Ross RS, Fishbein MC, Siegel RJ (March 1987). “Nonbacterial thrombotic endocarditis: a review”. Am. Heart J. 113 (3): 773–84. doi:10.1016/0002-8703(87)90719-8. PMID 3548296.
  4. ↑ Borowski A, Ghodsizad A, Cohnen M, Gams E (June 2005). “Recurrent embolism in the course of marantic endocarditis”. Ann. Thorac. Surg. 79 (6): 2145–7. doi:10.1016/j.athoracsur.2003.12.024. PMID 15919332.
  5. ↑ Aryana A, Esterbrooks DJ, Morris PC (December 2006). “Nonbacterial thrombotic endocarditis with recurrent embolic events as manifestation of ovarian neoplasm”. J Gen Intern Med. 21 (12): C12–5. doi:10.1111/j.1525-1497.2006.00614.x. PMC 1924740. PMID 16965557.
  6. ↑ Singhal AB, Topcuoglu MA, Buonanno FS (May 2002). “Acute ischemic stroke patterns in infective and nonbacterial thrombotic endocarditis: a diffusion-weighted magnetic resonance imaging study”. Stroke. 33 (5): 1267–73. doi:10.1161/01.str.0000015029.91577.36. PMID 11988602.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aisha Adigun, B.Sc., M.D.[2]