What is your approach to diagnosis and evaluation of nonbacterial thrombotic endocarditis (Libman-Sacks)?

Nonbacterial thrombotic endocarditis (NBTE), also known as Libman-Sacks endocarditis, is a form of endocarditis characterized by the presence of sterile vegetations on cardiac valves. It is most commonly associated with systemic autoimmune conditions, notably systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS), but can also be seen in the context of malignancy and other hypercoagulable states. The approach to diagnosis and evaluation of NBTE involves several key steps:

Clinica...

Noninfectious endocarditis is best divided into inflammatory vegetation best illustrated by Libman Sacks lesions vs, in the alternative, a primary thrombotic vegetation also known both as marantic and, less commonly in literature, as murantic endocarditis and associates with hypercoagulable states such as APS and other inherited or acquired thrombophilic states most especially adenocarcinomas. The literature also refers to these lesions whether principally inflammatory or thrombotic as non-infec...

What is the microscopic composition of the vegetations? If Non-thrombotic, Non-infectious, seems no role for anticoagulation.