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Bacteremia secondary to a recent dental procedure
25%
59/238
Aberrant flow causing platelet-fibrin thrombus formation secondary to hypercoagulability and malignancy
8%
20/238
Bacteremia secondary to a urinary tract infection
11%
25/238
Immune complex deposition and subsequent inflammation
51%
122/238
Left atrial mass causing a ball valve-type outflow obstruction
3%
6/238
Select Answer to see Preferred Response
This patient's signs and symptoms point to a diagnosis of systemic lupus erythematosus (SLE). Libman-Sacks endocarditis is a sterile/inflammatory endocarditis that is commonly associated finding with SLE. Libman-Sacks endocarditis (LSE) is a type of endocarditis that is not caused by bacteria. It is one of the most common cardiac findings associated with lupus, occurring in up to 25% of SLE patients. The mitral valve is most commonly affected, with small vegetations appearing on both sides of the valve. These vegetations can cause mitral valve leaflet thickening; however, this is usually an asymptomatic process. Illustration A depicts the verrucous valvular vegetations of LSE. Incorrect Answers: Answer 1: Subacute bacterial endocarditis would not be expected in a patient with lupus without other incriminating historical data. Answer 2: Nonbacterial thrombotic endocarditis, also known as marantic endocarditis, is a paraneoplastic syndrome seen most often with primary GI cancers. These may cause emboli to the periphery. Answer 3: Acute bacterial endocarditis is usually caused by S. aureus in IV drug abusers. Answer 5: Atrial myxomas are benign cardiac tumors that would not be expected to be seen in a patient with lupus.
3.0
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