Non-bacterial Thrombotic Endocarditis and Coronary Thrombectomy in a Patient with Metastatic Small Cell Lung Carcinoma

Overview

Journal BMJ Case Rep

Specialty General Medicine

Date 2021 Jun 22

PMID 34155006

Citations 3

Authors

Kelsey Margaret Gray

Bao Nguyen

Larissa Baker

Masood Ahmad

Affiliations

Soon will be listed here.

Abstract

A 66-year-old Caucasian man was initially admitted with a metastatic small cell lung carcinoma, hyponatraemia and obstructive pneumonia. His transthoracic echocardiogram (TTE) was normal. Ten days after admission, he was diagnosed with a non-ST segment elevation myocardial infarction (MI). Both a repeated TTE and a transoesophageal echocardiogram identified thickened, myxomatous mitral valve leaflet tips with small, mobile masses identified as vegetations, and new, eccentric, severe mitral regurgitation. Subsequent cardiac catheterisation recorded thrombotic occlusion of the right coronary artery. Successful coronary thrombectomy was carried out, but the patient died. A diagnosis of non-bacterial thrombotic endocarditis leading to coronary embolisation and MI was made. The clinical course and treatment choices are discussed.

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References

Kearon C, Akl E, Ornelas J, Blaivas A, Jimenez D, Bounameaux H . Antithrombotic Therapy for VTE Disease: CHEST Guideline and Expert Panel Report. Chest. 2016; 149(2):315-352. DOI: 10.1016/j.chest.2015.11.026. View

Bathina J, Daher I, Plana J, Durand J, Yusuf S . Acute myocardial infarction associated with nonbacterial thrombotic endocarditis. Tex Heart Inst J. 2010; 37(2):208-12. PMC: 2851431. View

Scalia G, Tandon A, Robertson J . Stroke, aortic vegetations and disseminated adenocarcinoma--a case of marantic endocarditis. Heart Lung Circ. 2011; 21(4):234-6. DOI: 10.1016/j.hlc.2011.08.003. View

Kaufmann C, Wessely E, Huber K . Non-bacterial thrombotic endocarditis in the context of pulmonary adenocarcinoma: a case report. Eur Heart J Case Rep. 2020; 4(1):1-5. PMC: 7047059. DOI: 10.1093/ehjcr/ytaa008. View

Sia C, Lim J, Poh K, Chin T . A classical case of non-bacterial thrombotic endocarditis from pancreatic adenocarcinoma presenting as multiple strokes, myocardial infarction and acute limb ischaemia. Oxf Med Case Reports. 2016; 2016(11):omw084. PMC: 5184836. DOI: 10.1093/omcr/omw084. View

Mazokopakis E, Syros P, Starakis I . Nonbacterial thrombotic endocarditis (marantic endocarditis) in cancer patients. Cardiovasc Hematol Disord Drug Targets. 2010; 10(2):84-6. DOI: 10.2174/187152910791292484. View

Salem D, Stein P, Al-Ahmad A, Bussey H, Horstkotte D, Miller N . Antithrombotic therapy in valvular heart disease--native and prosthetic: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004; 126(3 Suppl):457S-482S. DOI: 10.1378/chest.126.3_suppl.457S. View

Lopez J, Ross R, Fishbein M, Siegel R . Nonbacterial thrombotic endocarditis: a review. Am Heart J. 1987; 113(3):773-84. DOI: 10.1016/0002-8703(87)90719-8. View

Lee V, Gilbert J, Byard R . Marantic endocarditis - A not so benign entity. J Forensic Leg Med. 2012; 19(6):312-5. DOI: 10.1016/j.jflm.2012.02.021. View

10.

Rogers L, Cho E, Kempin S, Posner J . Cerebral infarction from non-bacterial thrombotic endocarditis. Clinical and pathological study including the effects of anticoagulation. Am J Med. 1987; 83(4):746-56. DOI: 10.1016/0002-9343(87)90908-9. View

11.

Chino F, Kodama A, Otake M, Dock D . Nonbacterial thrombotic endocarditis in a Japanese autopsy sample. A review of eighty cases. Am Heart J. 1975; 90(2):190-8. DOI: 10.1016/0002-8703(75)90119-2. View

12.

Mantovani F, Navazio A, Barbieri A, Boriani G . A first described case of cancer-associated non-bacterial thrombotic endocarditis in the era of direct oral anticoagulants. Thromb Res. 2016; 149:45-47. DOI: 10.1016/j.thromres.2016.11.016. View

13.

Asopa S, Patel A, Khan O, Sharma R, Ohri S . Non-bacterial thrombotic endocarditis. Eur J Cardiothorac Surg. 2007; 32(5):696-701. DOI: 10.1016/j.ejcts.2007.07.029. View

14.

Edoute Y, Haim N, Rinkevich D, Brenner B, Reisner S . Cardiac valvular vegetations in cancer patients: a prospective echocardiographic study of 200 patients. Am J Med. 1997; 102(3):252-8. DOI: 10.1016/S0002-9343(96)00457-3. View

15.

Sack Jr G, Levin J, Bell W . Trousseau's syndrome and other manifestations of chronic disseminated coagulopathy in patients with neoplasms: clinical, pathophysiologic, and therapeutic features. Medicine (Baltimore). 1977; 56(1):1-37. View

16.

Tiong I, Williams M, Perez D . Nonbacterial thrombotic endocarditis with ST-elevation myocardial infarction treated with percutaneous coronary aspiration thrombectomy. Heart Lung Circ. 2012; 22(5):386-9. DOI: 10.1016/j.hlc.2012.10.013. View

17.

Lee A, Levine M, Baker R, Bowden C, Kakkar A, Prins M . Low-molecular-weight heparin versus a coumarin for the prevention of recurrent venous thromboembolism in patients with cancer. N Engl J Med. 2003; 349(2):146-53. DOI: 10.1056/NEJMoa025313. View

18.

Kuramoto K, Matsushita S, Yamanouchi H . Nonbacterial thrombotic endocarditis as a cause of cerebral and myocardial infarction. Jpn Circ J. 1984; 48(9):1000-6. DOI: 10.1253/jcj.48.1000. View