In a patient, mitral valve vegetations are seen along the lines of closure along with fusion of commissures. What is the likely diagnosis?
A. Bacterial endocarditis
B. Libman-Sacks endocarditis
C. Rheumatic endocarditis
D. Marantic endocarditis
Ans: C. Rheumatic endocarditis
(Ref: Robbins 9/e p560)
- The given image is showing small vegetations in a row along the lines of closure of valves and commissural fusion.
- This is typically seen in rheumatic endocarditis.
- “The rheumatic fever phase of rheumatic heart disease (RHD) is marked by small, warty vegetations along the lines of closure of the valve leaflets. Infective endocarditis (IE) is characterized by large, irregular masses on the valve cusps that can extend onto the chordae.
- Nonbacterial thrombotic endocarditis (NBTE) typically exhibits small, bland vegetations, usually attached at the line of closure.
- Libman-Sacks endocarditis (LSE) has small or medium-sized vegetations on either or both sides of the valve leaflets.