A 68-year-old man has been very ill for months following the onset of chronic liver disease with hepatitis C infection. He experiences a sudden loss of consciousness and then exhibits hemiplegia on the right. A cerebral angiogram reveals lack of perfusion in the left middle cerebral artery distribution.
The most likely cardiac lesion to be associated with this finding is?
A- Acute rheumatic fever
B- Left atrial myxoma
C- Libman-Sacks endocarditis
D- Non-bacterial thrombotic endocarditis
E- Paradoxical thromboembolus
Answer:
D- Non-bacterial thrombotic endocarditis
Discussion: Marantic endocarditis has platelet-fibrin thrombi that are prone to embolize. This form of non-infective endocarditis can be seen in persons who are very debilitated or who have a hypercoagulable state.
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