A 61-year-old woman with metastatic pancreatic adenocarcinoma presents with acute right arm weakness. Vital signs: BP 128/76 mmHg, HR 92/min, RR 16/min, Temp 37.2°C, SpO2 98% on room air. She denies fever or chills. Blood cultures remain negative after 48 hours. Transthoracic echocardiography reveals small, sterile vegetations along the mitral valve closure line. Prothrombin time is elevated at 16 seconds. Which of the following is the most likely diagnosis?
- A)Nonbacterial thrombotic endocarditisGABARITO
- B)Acute infective endocarditis
- C)Papillary fibroelastoma
- D)Libman Sacks endocarditis
- E)Rheumatic heart disease
Explicação
Nonbacterial thrombotic endocarditis is correct. Hypercoagulable states, especially advanced mucinous adenocarcinoma, can produce sterile platelet fibrin vegetations on cardiac valves that embolize systemically. The absence of fever and persistently negative c... Ver explicação completa e trilha adaptativa →