Antemortem diagnosis of nonbacterial thrombotic endocarditis in a patient with previously resected pancreatic adenocarcinoma: a case report

European Heart Journal. Case Reports
Hamza Zahid Ullah MuhammadzaiHaissam Haddad

Abstract

Nonbacterial thrombotic endocarditis (NBTE) is a rare manifestation of a number of systemic diseases, which include advanced malignancy and hypercoagulable states. We present a 67-year-old woman who had presented with chest pain and heart failure. Eight years ago, she had a successful Whipple resection for pancreatic adenocarcinoma. Echocardiography revealed mitral valve vegetations with negative blood cultures. She had multiple infarcts in the kidney, spleen, and brain. She was found to have a mass in the left 8th rib, consistent with metastatic pancreatic adenocarcinoma on biopsy. Ultimately, a diagnosis of NBTE was made after excluding other causes for her presentation. Because of her general poor condition, she expressed the wish for palliative care and later died 28 days after presentation. This case illustrates the possibility of NBTE in patients successfully treated for pancreatic adenocarcinoma and highlights the consideration of this relatively rare differential in patients with a previously treated malignancy presenting with heart failure.

References

Mar 1, 1987·American Heart Journal·J A LopezR J Siegel
Sep 1, 1984·Japanese Circulation Journal·K KuramotoH Yamanouchi
Sep 21, 2007·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Sanjay AsopaSunil K Ohri
Apr 22, 2009·The Journal of Thoracic and Cardiovascular Surgery·Naoko NaganoLawrence Rudski
Jan 1, 2009·Case Reports in Gastroenterology·Gayle S JamesonDaniel Von Hoff

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Citations

Aug 4, 2021·The American Journal of Medicine·Mohammad A ZmailiBo Xu

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Methods Mentioned

BETA
biopsy

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