A 56-Year-Old Woman with Unknown Medical History Is Brought to the Emergency

A 56-year-old woman with unknown medical history is brought to the emergency department in an unresponsive state.  Paramedics were called for sudden-onset, left-sided weakness, and when they arrived at the patient's house she was having a generalized tonic-clonic seizure.  Antiseizure medications were given and the patient was subsequently intubated.  Evaluation shows a comatose woman with left hemiplegia.  Neuroimaging reveals a large infarction in the right middle cerebral artery territory with cerebral edema.  Despite aggressive interventions, the patient dies from brain herniation.  Autopsy reveals multiple small, nondestructive masses attached to the edges of the mitral valve leaflets.  Microscopy shows that these masses are composed of platelet-rich thrombi, but no organisms are present.  Which of the following is most closely associated with this patient's heart valve findings?

A) Advanced malignancy
B) Chronic liver failure
C) Dilated cardiomyopathy
D) Intravenous drug use
E) Large-vessel vasculitis

Correct Answer:

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