Non-bacterial thrombotic endocarditis in the context of pulmonary adenocarcinoma: a case report

European Heart Journal. Case Reports
Christoph C KaufmannKurt Huber

Abstract

Non-bacterial thrombotic endocarditis (NBTE) is a rare condition, usually observed in association with malignancy, lupus erythematosus, or antiphospholipid syndrome. Diagnosis of NBTE remains a challenge as patients are often asymptomatic up to their first thromboembolic event. While there is no randomized data available for the guidance of treatment in NBTE, effective anticoagulation remains the main focus in the management of affected patients. A 44-year-old female patient without a significant medical history presented to the emergency department with a new numbness of her right hand. Magnetic resonance imaging scans facilitated the diagnosis of supratentorial stroke. Within the next 3 months, the patient had multiple thromboembolic events, including multiple strokes, pulmonary embolism, and renal/splenic infarction. Echocardiographic examination revealed large, transient vegetations of the aortic valve with concomitant aortic regurgitation. In addition, an incidental, pulmonary non-small-cell adenocarcinoma was found during the diagnostic work-up. Infective endocarditis was excluded by several negative blood cultures and missing signs of infection. Hence, the diagnosis of NBTE secondary to malignancy was made. We present a ...Continue Reading

References

Sep 21, 2007·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Sanjay AsopaSunil K Ohri
Sep 14, 2013·JACC. Cardiovascular Imaging·Carlos A RoldanKendall Crookston
Aug 9, 2016·Cardiology in Review·Joshua Liu, William H Frishman
Nov 21, 2017·The New England Journal of Medicine·Jean-Charles SoriaUNKNOWN FLAURA Investigators

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