In the non-infectious endocarditis (nonbacterial thrombotic endocarditis) leads to the formation of sterile thrombi from fibrin and platelets in the heart valves and the adjacent endocardium. Such thrombi arise due to an injury, circulating immune complexes, vasculitis or increased coagulability. The symptoms are similar to those of systemic arterial embolism. The diagnosis results from the echocardiogram and out of negative blood cultures. The therapy consists of the administration of anticoagulants.
In the non-infectious endocarditis (nonbacterial thrombotic endocarditis) leads to the formation of sterile thrombi from fibrin and platelets in the heart valves and the adjacent endocardium. Such thrombi arise due to an injury, circulating immune complexes, vasculitis or increased coagulability. The symptoms are similar to those of systemic arterial embolism. The diagnosis results from the echocardiogram and out of negative blood cultures. The therapy consists of the administration of anticoagulants. Etiology The vegetation does not occur due to an infection, but due to a physical injury. They either go undetected or be the starting point for infective endocarditis, lead to embolism or to an impairment of valve function. At a right heart catheterization may lead to a violation of the tricuspid and pulmonary valve. to platelets and fibrin attach to such an injury. In diseases such as systemic lupus erythematosus, immune complexes may fix (Libman-Sacks lesions) is circulating in the form of wärzchenförmigen deposits of fibrin-platelet vegetations along the valve leaflets. Such lesions do not usually lead to a significant valve obstruction or insufficiency. The antiphospholipid antibody syndrome (with lupus anticoagulant, recurrent venous thrombosis, stroke, spontaneous abortions and livedo reticularis) can also sterile Endokardvegetationen and systemic embolism cause. Rarely the lead granulomatosis with polyangiitis to a non-infectious endocarditis. Maran tables endocarditis in patients with chronic consumptive diseases, disseminated intravascular coagulation, muzinproduzierenden metastatic cancers (lung, stomach or pancreas) or in chronic infections such as tuberculosis, pneumonia, or osteomyelitis large thrombotic vegetations may form on the flaps and significant embolisms in the brain, kidneys, spleen, mesentery, causing extremities and coronary arteries. Such growths are formed more like congenitally altered or previously damaged by rheumatic fever flaps. Symptoms and complaints The vegetation itself make any symptoms. Symptoms show up only as a result of an embolism and vary depending on the organ affected (eg., Brain, kidney or spleen). In some cases, the patient developed fever and heart murmur. Diagnostic blood cultures echocardiography The suspected non-infectious endocarditis is given when the chronically ill develop symptoms that suggests an arterial embolism. The diagnosis results from serial blood cultures (diagnosis) and echocardiogram. (But not atrial myxoma) negative blood cultures and flaps vegetations substantiate the suspicion of a non-infectious endocarditis. The diagnosis can be confirmed by examination of embolic material which has been taken at an embolectomy. The differential diagnosis to distinguish from an infectious endocarditis can be difficult with negative blood cultures, but it is important. Non-infectious endocarditis treatment with anticoagulants in infectious form is often essential, but contraindicated. Prognosis The prognosis is generally poor rather due to the severity of other underlying diseases as a result of Herzläsion. Treatment anticoagulation therapy consists of anticoagulation with heparin or warfarin, although studies on the effectiveness of this treatment has not been available. Where possible, the causative underlying diseases should be treated.