Lee Vivian, Gilbert John D, Byard Roger W
Discipline of Anatomy and Pathology, Level 3 Medical School North Building, The University of Adelaide, Frome Rd, Adelaide, SA, 5000, Australia.
J Forensic Leg Med. 2012 Aug;19(6):312-5. doi: 10.1016/j.jflm.2012.02.021. Epub 2012 Mar 5.
Marantic, verrucous or nonbacterial thrombotic endocarditis, is characterised by the deposition of an amorphous mixture of fibrin and platelets onto heart valves. Although not commonly a cause of death in forensic practice, it may be associated with systemic embolisation. This was observed in a 60-year-old woman who suddenly collapsed and was found at autopsy to have a poorly differentiated adenocarcinoma of the lung with vegetations from marantic endocarditis on the mitral valve and embolisation with infarcts in the left kidney, the spleen, the right occipital cortex of the brain and the left ventricle of the heart. Death was due to coronary artery embolism from marantic endocarditis associated with an undiagnosed adenocarcinoma of the lung. Although marantic endocarditis is more common in hospital autopsies than in forensic cases, it can have lethal complications that result in sudden and unexpected death. Histories of debilitating disease and/or arterial thromboembolic episodes necessitate meticulous examination of the cardiac valves with careful serial sectioning of the major epicardial coronary arteries and histologic sampling of both ventricles.
消耗性、疣状或非细菌性血栓性心内膜炎，其特征是在心脏瓣膜上沉积纤维蛋白和血小板的无定形混合物。虽然在法医实践中通常不是死亡原因，但它可能与全身栓塞有关。在一名60岁女性中观察到这种情况，该女性突然晕倒，尸检发现患有低分化肺腺癌，二尖瓣有消耗性心内膜炎的赘生物，并且左肾、脾脏、脑右枕叶皮质和心脏左心室有梗死性栓塞。死亡原因是与未诊断出的肺腺癌相关的消耗性心内膜炎导致的冠状动脉栓塞。尽管消耗性心内膜炎在医院尸检中比在法医病例中更常见，但它可能有致命并发症，导致突然和意外死亡。有衰弱性疾病和/或动脉血栓栓塞发作史的情况需要对心脏瓣膜进行细致检查，对主要的心外膜冠状动脉进行仔细的连续切片，并对两个心室进行组织学取样。
