cardiovascular disorders
Noninfective Endocarditis
Etiology of Noninfective Endocarditis
Vegetations are not caused by infection. They may be clinically undetectable or become a nidus for infection (leading to infective endocarditis), produce emboli, or cause valvular dysfunction. Valve destruction is uncommon. Catheters passed through the right side of the heart may injure the tricuspid and pulmonic valves, resulting in platelet and fibrin attachment at the site of injury. In disorders such as Systemic Lupus Erythematosus (SLE) , circulating immune complexes may result in friable platelet and fibrin vegetations along a valve leaflet closure (Libman-Sacks lesions). These lesions do not usually cause significant valvular obstruction or regurgitation. In patients with chronic wasting diseases, Disseminated Intravascular Coagulation (DIC) , mucin-producing metastatic carcinomas (eg, of lung, stomach, or pancreas), or chronic infections (eg, 