Mechanical Mitral Valve Thrombosis in a Patient With Prior Nonbacterial Thrombotic Endocarditis

Abstract

A 54-year-old woman with a mechanical mitral valve replacement presented with recurrent admissions for pneumonia and pulmonary edema. Multimodality imaging revealed mobile masses on the prosthesis and discrepant point of care and inpatient international normalized ratio levels owing to antiphospholipid antibody cross-reactivity on the outpatient assay. The prosthetic valve thromboses resolved with therapeutic anticoagulation. (Level of Difficulty: Beginner.)

Keywords

• antiphospholipid syndrome
• antithrombotic therapies
• mitral valve disease
• nonbacterial thrombotic endocarditis
• prosthetic valve thrombosis