Clinical findings:
(1) history of a condition associated with nonbacterial endocarditis (see previous section)
(2) arterial and/or pulmonary thromboemboli
Arterial thromboemboli can go to:
(1) the coronary arteries, with acute myocardial infarction
(2) the cerebral arteries, with stroke
(3) the mesenteric arteries, with ischemic bowel disease
(4) the renal arteries, with renal infarctions
(5) arteries in the extremities
(6) small arteries in the skin or conjunctiva, with splinter hemorrhages or Roth spots
Imaging findings:
(1) vegetations on one or more cardiac valves, best seen on echocardiography
Laboratory findings:
(1) negative blood cultures
(2) elevated D-dimer
(3) fibrinogen may be decreased, normal or elevated
The vegetations may become infected if the patient develops bacteremia but this process would be hard to document.
