Developer site: The content shown here is test data.

MyEClinic
MyEClinic
Health Dictionary AI Health Chat Find an Online Doctor
A serene Zen garden with raked sand and smooth stones, symbolising clarity and calm

Health Dictionary

Reliable, easy-to-read patient information on common medical conditions ā€” 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.

Back to skin conditions

Non-bacterial thrombotic endocarditis medical therapy

Introduction

Overview

Overview

There is no treatment for nonbacterial thrombotic endocarditis; the mainstay of therapy is the identification and treatment of the underlying condition, with an aim to reduce the risk of systemic embolism. Unless there is a specific contraindication, anticoagulation with IV unfractionated heparin or subcutaneous low molecular weight heparin is recommended in all patients with a clinical diagnosis of NBTE.

Medical Therapy

Medical Therapy

  • Pharmacologic medical therapy is recommended among all patients with non-bacterial thrombotic endocarditis[1].
  • Due to the fragility of vegetation and the high rate of embolization in patients with NBTE, anticoagulation is recommended provided there are no contraindications[2].
  • As there is a risk of conversion of embolism to hemorrhage, a base-line head CT is recommended prior to the start of anticoagulants[3].
  • IV unfractionated heparin or subcutaneous low molecular weight heparin is recommended[3].
  • Provided there are no acute contraindications, anticoagulation should be continued indefinitely in all patients[4][5].
References

References

  1. ā†‘ Lopez JA, Ross RS, Fishbein MC, Siegel RJ (March 1987). “Nonbacterial thrombotic endocarditis: a review”. Am. Heart J. 113 (3): 773ā€“84. doi:10.1016/0002-8703(87)90719-8. PMIDĀ 3548296.
  2. ā†‘ el-Shami K, Griffiths E, Streiff M (May 2007). “Nonbacterial thrombotic endocarditis in cancer patients: pathogenesis, diagnosis, and treatment”. Oncologist. 12 (5): 518ā€“23. doi:10.1634/theoncologist.12-5-518. PMIDĀ 17522239.
  3. ā†‘ 3.0 3.1 Whitlock RP, Sun JC, Fremes SE, Rubens FD, Teoh KH (February 2012). “Antithrombotic and thrombolytic therapy for valvular disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines”. Chest. 141 (2 Suppl): e576Sā€“e600S. doi:10.1378/chest.11-2305. PMCĀ 3278057. PMIDĀ 22315272.
  4. ā†‘ Fujimoto D, Mochizuki Y, Nakagiri K, Shite J (November 2018). “Unusual rapid progression of non-bacterial thrombotic endocarditis in a patient with bladder cancer despite undergoing intensification treatment with rivaroxaban for acute venous thromboembolism”. Eur. Heart J. 39 (43): 3907. doi:10.1093/eurheartj/ehy569. PMIDĀ 30203033.
  5. ā†‘ Rogers LR, Cho ES, Kempin S, Posner JB (October 1987). “Cerebral infarction from non-bacterial thrombotic endocarditis. Clinical and pathological study including the effects of anticoagulation”. Am. J. Med. 83 (4): 746ā€“56. doi:10.1016/0002-9343(87)90908-9. PMIDĀ 3674060.

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