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Behind Recurrent Thromboembolic Events.

Sara Guerreiro1, Carolina Gouveia2, Rita Mora de Féria3

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|February 14, 2019
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Summary

Recurrent thromboembolic events without infection suggest marantic endocarditis, a non-bacterial condition often linked to cancer. This case highlights the diagnostic challenge of marantic endocarditis, especially when differentiating it from infective endocarditis.

Keywords:
Marantic endocarditispancreatic adenocarcinomathromboembolism

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Area of Science:

  • Cardiology
  • Oncology
  • Pathology

Background:

  • Marantic endocarditis involves non-bacterial thrombotic deposits on heart valves.
  • It is frequently associated with underlying malignancy and carries a high risk of thromboembolic events.

Purpose of the Study:

  • To present a case of marantic endocarditis initially presenting as ischemic stroke and peripheral emboli.
  • To emphasize the diagnostic challenges in distinguishing marantic endocarditis from infective endocarditis.

Main Methods:

  • Case report of a 68-year-old male with recurrent embolic events.
  • Clinical evaluation, including cardiac embolization workup and autopsy findings.
  • Histopathological examination of the mitral valve.

Main Results:

  • The patient experienced an ischemic stroke and recurrent peripheral embolic events.
  • Blood cultures and valve histology were negative for microorganisms.
  • Pancreatic adenocarcinoma was diagnosed posthumously, consistent with marantic endocarditis.

Conclusions:

  • Recurrent thromboembolic events with negative cultures suggest marantic endocarditis.
  • Marantic endocarditis is a diagnostic challenge, often associated with neoplasia.
  • High clinical suspicion is crucial for early diagnosis and management.