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Korean Circ J. 2016 May;46(3):425-428. English. Case Report. https://doi.org/10.4070/kcj.2016.46.3.425
Choi JH , Park JE , Kim JY , Kang T .
Department of Rheumatology, Yonsei University Wonju College of Medicine, Wonju, Korea. taeyoung@yonsei.ac.kr
Department of Cardiology, Yonsei University Wonju College of Medicine, Wonju, Korea.
Abstract

Rheumatoid arthritis (RA) is frequently associated with various extra-joint complications. Although rare, thromboembolic complications are associated with high morbidity and mortality. We experienced a very rare case of nonbacterial thrombotic endocarditis (NBTE) and subsequent embolic stroke in a patient with RA. A 72-year-old male with a 15-year history of RA suddenly developed neurologic symptoms of vomiting and dizziness. Brain magnetic resonance imaging revealed recently developed multiple cerebellar and cerebral lacunar infarctions. Echocardiography showed a pulsating mitral valve vegetation involving the posterior cusp of the mitral valve leaflet, which was confirmed as NBTE. Immediate anti-coagulation therapy was started. The NBTE lesion disappeared in follow-up echocardiography after 4 weeks of anti-coagulation treatment.

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